Major Hepatic Resection Following Portal Vein Embolisation: Indications, Technique and Peri-Operative Outcome

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Author Info

Ahmad Mirza Arslan Pannu Eloise Lawrence Ghulam Murtaza Dar Khurram Khan Rishabha Sharma Salman Jabbar Shahzad Ahmed

Corresponding Author

Ahmad Mirza
Department of Abdominal Transplant and Hepato-Biliary Surgery, University of Cincinnati Medical Center, Ohio, USA

A B S T R A C T

Major liver resections are limited by the volume of future liver (FLR) remnant with the risk of subjecting patient to post surgery liver failure. This increases morbidity and mortality of the patients. However, the technique of ipsilateral portal vein embolisation (PVE) has given surgeons extra mileage to consider major liver resections previously thought to be unresectable. Al cases should be discussed in a multidisciplinary setting. A good knowledge of portal anatomy and variations should be known as part of selection procedure for PVE. Base liver functional status should be reviewed before consideration given to PVE. CT volumetry assessment should be made before and after PVE to assess for resectability. Multiple embolic materials are used in current practice, but none have shown superiority. Several complications are related to application of PVE, however it is generally regarded a safe procedure. Atleast four weeks are required to assess for FLR with repeat abdominal cross-sectional imaging. Patients with normal liver function tests achieve maximum hypertrophy in four weeks versus patients with underlying liver disease. Liver surgery is scheduled upto 2 to 6 weeks following embolisation. The aim of this article is to provide an overview of current indications, technique, complications and outcomes following PVE.

Article Info

Article Type

Review Article

Publication history

Received: Mon 11, Nov 2019
Accepted: Wed 27, Nov 2019
Published: Fri 03, Jan 2020

Copyright

© 2023 Ahmad Mirza. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.COR.2019.06.07