Present status and future perspectives of preoperative portal vein embolization

Am J Surg. 2009 May;197(5):686-90. doi: 10.1016/j.amjsurg.2008.04.022. Epub 2009 Feb 27.

Abstract

Background: Portal vein embolization (PVE) has been gaining increasing acceptance before major hepatectomy. This review presents the application, outcome, and recent developments of PVE.

Methods: After a systematic search of "portal vein embolization" in PubMed, we reviewed and retrieved articles written in English related to PVE. There were no other criteria for exclusion of published information pertaining to this topic.

Results: Hypertrophy of future liver remnants with PVE in patients with hepatobiliary malignancy results in fewer complications and shorter hospital stays after major hepatectomy, and add to the pool of candidates for surgical treatment. Some new techniques, such as sequential hepatic artery-portal vein embolization and PVE with stem cell administration, have showed a promising clinical future.

Conclusions: PVE has achieved significant improvement in the outcome of major hepatectomy, and has enlarged the candidate pool of liver resection as well. Future study is needed to identify the precise mechanism of liver regeneration after PVE.

Publication types

  • Review

MeSH terms

  • Animals
  • Embolization, Therapeutic*
  • Hepatectomy*
  • Humans
  • Liver / physiopathology
  • Liver Failure / physiopathology
  • Liver Neoplasms / surgery*
  • Portal Vein
  • Preoperative Care*