Preoperative Portal Vein Embolization before Major Hepatic Resection in Bile Duct Tumor: A Preliminary Report

Authors

  • Ake Pugkhem Department of Surgery, Faculty of Medicine. Khon Kaen University Khon Kaen, Thailand
  • Vallop Loapaiboon Department of Radiology, Faculty of Medicine. Khon Kaen University Khon Kaen, Thailand
  • Vajarabhongsa Bhudhisawasdi Department of Surgery, Faculty of Medicine. Khon Kaen University Khon Kaen, Thailand
  • Narong Khuntikeo Department of Surgery, Faculty of Medicine. Khon Kaen University Khon Kaen, Thailand
  • Thongueb Uttaravichien Department of Surgery, Faculty of Medicine. Khon Kaen University Khon Kaen, Thailand

Abstract

Introduction: Major hepatic resections in patients with chronic parenchymal or cholestatic liver diseases are associated with significant morbidity and mortality. Preoperative portal vein embolization to induce hypertrophy of future liver remnant may result in the increase of operative safety.

Materials and Methods: The medical records of 8 patients who underwent major hepatectomies after portal vein embolization from 2003 to 2004 were retrieved. Demographic data, technique of portal vein embolization, estimated standard liver volume, post portal vein embolization future liver remnant volume, morbidity and mortality were collected and analysed.

Results: Four men and 4 women (average age 56.6 years) with liver diseases including 6 intraductal papillary mucinous tumours of bile duct, 4 benign lesions, 2 malignant lesions and 2 hilar cholangiocarcinoma were included in this study. Left percutaneous transhepatic biliary drainage was performed before right portal vein embolization in 3 cases. Migration of embolized substance to contralateral lobe occurred in I case. The average ratio of future liver remnant volume and estimated standard liver volume was 52.75%. Major hepatic resection was performed in all. There was subphrenic collection in 1 case which was successfully treated by percutaneous drainage. No postoperative liver failure or mortality was encountered. 

Conclusions: Preoperative portal vein embolization before major hepatic resection is safe. Atrophy of the affected lobe makes it easier in mobilization and control of bleeding.

References

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Published

2008-06-30

How to Cite

1.
Pugkhem A, Loapaiboon V, Bhudhisawasdi V, Khuntikeo N, Uttaravichien T. Preoperative Portal Vein Embolization before Major Hepatic Resection in Bile Duct Tumor: A Preliminary Report. Thai J Surg [Internet]. 2008 Jun. 30 [cited 2024 Nov. 23];29(2):49-53. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/240881

Issue

Vol. 29 No. 2 (2008): April - June

Section

Original Articles

License

Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.