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Portal Vein Embolization

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Vascular Embolotherapy

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Conclusion

PVE is a safe technique allowing efficient preoperative hypertrophy of the FRL in selected cases. It is recommended to perform distal embolization rather than proximal occlusion or ligation. Embolic agents producing high local inflammatory reaction induce greater hypertrophy than others do.

PVE neither improves nor worsens long-term prognosis but it allows curative resection in patients that otherwise are considered as unresectable. Nowadays, it may be frequently combined with multiple other efficient therapeutic modalities (systemic or intraarterial chemotherapy, chemoembolization, radiofrequency ablation) in order to lead more patients with malignant liver tumor to radical surgery.

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References

  1. Abdalla EK, Hicks ME, Vauthey JN (2001) Portal vein embolization: rationale, technique and future prospects. Br J Surg 88:165–175

    Article  PubMed  CAS  Google Scholar 

  2. Abdalla EK, Barnett CC, Doherty D et al. (2002) Extended hepatectomy in patients with hepatobiliary malignancies with and without preoperative portal vein embolization. Arch Surg 137:675–680

    PubMed  Google Scholar 

  3. Adam R, Lucidi V, Bismuth H (2004) Hepatic colorectal metastases: methods of improving resectability. Surg Clin North Am 84:659–671

    Article  PubMed  Google Scholar 

  4. Azoulay D, Castaing D, Smail A et al. (2000a) Resection of nonresectable liver metastases from colorectal cancer after percutaneous portal vein embolization. Ann Surg 231:480–486

    Article  PubMed  CAS  Google Scholar 

  5. Azoulay D, Castaing D, Krissat J et al. (2000b) Percutaneous portal vein embolization increases the feasibility and safety of major liver resection for hepatocellular carcinoma in injured liver. Ann Surg 232:665–672

    PubMed  CAS  Google Scholar 

  6. Broering DC, Hillert C, Krupski G et al. (2002) Portal vein embolization vs. portal vein ligation for induction of hypertrophy of the future liver remnant. J Gastrointest Surg 6:905–913

    Article  PubMed  Google Scholar 

  7. Brown KT, Brody LA, Decorato DR et al. (2001) Portal vein embolization with use of polyvinyl alcohol particles. J Vasc Interv Radiol 12:882–886

    PubMed  CAS  Google Scholar 

  8. Bucher NLR, Swaffield MN (1975) Regulation of hepatic regeneration in rats by synergistic action of insulin and glucagon. Proc Natl Acad Sci USA 72:1157–1160

    PubMed  CAS  Google Scholar 

  9. Chijiiwa K, Saiki S, Noshiro H et al. (2000) Effect of preoperative portal vein embolization on liver volume and hepatic energy status of the nonembolized liver lobe in humans. Eur Surg Res 32:94–99

    Article  PubMed  CAS  Google Scholar 

  10. De Baere T, Roche A, Elias D et al. (1996) Preoperative portal vein embolization for extension of hepatectomy indications. Hepatology 24:1386–1391

    PubMed  Google Scholar 

  11. Denys AL, Abehsera M, Leloutre B et al. (2000) Intrahepatic hemodynamic changes following portal vein embolization: a prospective Doppler study. Eur Radiol 10:1703–1707

    Article  PubMed  CAS  Google Scholar 

  12. Elias D, de Baere T, Roche A et al. (1998) Preoperative selective portal vein embolizations are an effective means of extending the indications of major hepatectomy in normal and injuried liver. Hepatogastroenterology 45:170–177

    PubMed  CAS  Google Scholar 

  13. Elias D, de Baere T, Roche A et al. (1999) During liver regeneration following right portal embolization the growth rate of liver metastases is more rapid than that of the liver parenchyma. Br J Surg 86:784–788

    Article  PubMed  CAS  Google Scholar 

  14. Elias D, Ouellet JF, de Baere T et al. (2002) Preoperative selective portal vein embolization before hepatectomy for liver metastases: long-term results and impact on survival. Surgery 131:294–299

    Article  PubMed  Google Scholar 

  15. Farges O, Belghiti J, Kianmanesh R et al. (2003) Portal vein embolization before right hepatectomy: prospective clinical trial. Ann Surg 237:208–217

    Article  PubMed  Google Scholar 

  16. Fujii Y, Shimada H, Endo I et al. (2003) Effects of portal vein embolization before major hepatectomy. Hepatogastroenterology 50:438–442

    PubMed  Google Scholar 

  17. Gerunda GE, Bolognesi M, Neri D et al. (2002) Preoperative selective portal vein embolization (PSPVE) before major hepatic resection. Effectiveness of Doppler estimation of hepatic blood flow to predict the hypertrophy rate of nonembolized liver segments. Hepatogastr Oenterol 49:1405–1411

    Google Scholar 

  18. Goto Y, Nagino M, Nimura Y (1998) Doppler estimation of portal blood flow after percutaneous transhepatic portal vein embolization. Ann Surg 228:209–213

    Article  PubMed  CAS  Google Scholar 

  19. Harada H, Imamura H, Miyagawa S et al. (1997) Fate of the human liver after hemihepatic portal vein embolization: cell kinetic and morphometric study. Hepatology 26:1162–1170

    PubMed  CAS  Google Scholar 

  20. Hemming AW, Reed AI, Howard RJ et al. (2003) Preoperative portal vein embolization for extended hepatectomy. Ann Surg 237:686–691

    Article  PubMed  Google Scholar 

  21. Imamura H, Shimada R, Kubota M et al. (1999) Preoperative portal vein embolization: an audit of 84 patients. Hepatology 29:1099–1105

    Article  PubMed  CAS  Google Scholar 

  22. Jaeck D, Bachellier P, Nakano H et al. (2003) One or two-stage hepatectomy combined with portal vein embolization for initially nonresectable colorectal liver metastases. Am J Surg 185:221–229

    Article  PubMed  Google Scholar 

  23. Ji W, Liu WH, Ma KS et al. (2003) Preoperative selective portal vein embolization in two-step hepatectomy for hepatocellular carcinoma in injured livers: a preliminary report. Hepatobiliary Pancreat Dis Int 2:216–220

    PubMed  Google Scholar 

  24. Kaido T, Arii S, Shimada Y et al. (2003) Portal embolization in various types of liver: novel variables to predict hypertrophy. Hepatogastroenterology 50:140–145

    PubMed  Google Scholar 

  25. Kaneko T, Nakao A, Takagi H (2002) Clinical studies of new material for portal vein embolization: comparison of embolic effect with different agents. Hepatogastroenterology 49:472–477

    PubMed  Google Scholar 

  26. Kawai M, Naruse K, Komatsu S et al. (2002) Mechanical stress-dependent secretion of interleukin 6 by endothelial cells after portal vein embolization: clinical and experimental studies. J Hepatol 37:240–246

    Article  PubMed  CAS  Google Scholar 

  27. Kawasaki S, Makuuchi M, Kahazu T et al. (1994a) Resection for multiple metastatic liver tumors after portal embolization. Surgery 115:674–677

    PubMed  CAS  Google Scholar 

  28. Kawasaki S, Makuuchi M, Miyagawa S et al. (1994b) Radical operation after portal embolization for tumor of hilar bile duct. J Am Coll Surg 178:480–486

    PubMed  CAS  Google Scholar 

  29. Kinoshita H, Sakai K, Hirohashi K et al. (1986) Preoperative portal vein embolization for hepatocellular carcinoma. World J Surg 10:803–808

    Article  PubMed  CAS  Google Scholar 

  30. Ko GY, Sung KB, Yoon HK et al. (2003) Preoperative portal vein embolization with a new liquid embolic agent. Radiology 227:407–413

    PubMed  Google Scholar 

  31. Kodama Y, Shimizu T, Endo H et al. (2002) Complications of percutaneous transhepatic portal vein embolization. J Vasc Interv Radiol 13:1233–1237

    PubMed  Google Scholar 

  32. Kokudo N, Makuuchi M (2004) Current role of portal vein embolization/hepatic artery chemoembolization. Surg Clin North Am 84:643–657

    Article  PubMed  Google Scholar 

  33. Kokudo N, Tada K, Seki M et al. (2001) Proliferative activity of intrahepatic colorectal metastases after preoperative hemihepatic portal vein embolization. Hepatology 34:267–272

    Article  PubMed  CAS  Google Scholar 

  34. Kubo S, Shiomi S, Tanaka H et al. (2002) Evaluation of the effect of portal vein embolization on liver function by(99m)tc-galactosyl human serum albumin scintigraphy. J Surg Res 107:113–118

    PubMed  Google Scholar 

  35. Kusaka K, Imamura H, Tomiya T et al. (2004) Factors affecting liver regeneration after right portal vein embolization. Hepatogastroenterology 51:532–535

    PubMed  Google Scholar 

  36. Lee GE, Merlino G, Fausto N (1992) Development of liver tumors in transforming growth factor alpha transgenic mice. Cancer Res 52:5162–5170

    PubMed  CAS  Google Scholar 

  37. Lee KG, Kinoshita H, Hirohashi K et al. (1993) Extension of surgical indications for hepatocellular carcinoma by portal vein embolization. World J Surg 17:109–115

    Article  PubMed  CAS  Google Scholar 

  38. Madoff DC, Hicks ME, Abdalla EK et al. (2003) Portal vein embolization with polyvinyl alcohol particles and coils in preparation for major liver resection for hepatobiliary malignancy: safety and effectiveness-study in 26 patients. Radiology 227:251–260

    PubMed  Google Scholar 

  39. Makuuchi M, Thai BL, Takayasu K et al. (1990) Preoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report. Surgery 107:521–527

    PubMed  CAS  Google Scholar 

  40. Miyake H, Fujii M, Sasaki K et al. (2003) Heat shock protein 70 induction in hepatocytes after right portal vein embolization. Hepatogastroenterology 50:2084–2087

    PubMed  CAS  Google Scholar 

  41. Nagino M, Nimura Y, Kamiya J et al. (1995) Changes in hepatic lobe volume in biliary tract cancer patients after right portal vein embolization. Hepatology 21:434–439

    Article  PubMed  CAS  Google Scholar 

  42. Nagino M, Nimura Y, Kamiya J et al. (1996) Selective percutaneous transhepatic embolization of the portal vein in preparation for extensive liver resection: the ipsilateral approach. Radiology 200:559–563

    PubMed  CAS  Google Scholar 

  43. Nagino M, Kamiya J, Kanai M et al. (2000) Right trisegment portal vein embolization for biliary tract carcinoma: technique and clinical utility. Surgery 127:155–160

    Article  PubMed  CAS  Google Scholar 

  44. Nishiyama Y, Yamamoto Y, Hino I et al. (2003) 99mTc galactosyl human serum albumin liver dynamic SPET for pre-operative assessment of hepatectomy in relation to percutaneous transhepatic portal embolization. Nucl Med Commun 24:809–817

    Article  PubMed  CAS  Google Scholar 

  45. Panis Y, Ribeiro J, Chretien F et al. (1992) Dormant liver metastases: an experimental study. Br J Surg 79:221–223

    PubMed  CAS  Google Scholar 

  46. Perarnau JM, Daradkeh S, Johann M et al. (2003) Transjugular preoperative portal embolization (TJPE) a pilot study. Hepatogastroenterology 50:610–613

    PubMed  Google Scholar 

  47. Roche A, Soyer P, Elias D et al. (1991) Preoperative portal vein embolization for hepatic metastases. J Intervent Radiol 6:63–66

    Google Scholar 

  48. Shimada R, Imamura H, Nakayama A et al. (2002) Changes in blood flow and function of the liver after right portal vein embolization. Arch Surg 137:1384–1388

    PubMed  Google Scholar 

  49. Shimamura T, Nakajima Y, Une Y et al. (1997) Efficacy and safety of preoperative percutaneous transhepatic portal embolization with absolute ethanol: a clinical study. Surgery 121:135–141

    Article  PubMed  CAS  Google Scholar 

  50. Starzl TE, Francavilla A, Halgrimson CG (1973) The origin, hormonal nature and action of hepatotrophic substances in portal venous blood. Surg Gynecol Obst 137:179–199

    CAS  Google Scholar 

  51. Tominaga M, Ku Y, Iwasaki T et al. (2002) Effect of portal vein embolization on function of the nonembolized lobes of the liver: evaluation by firstpass hepatic lidocaine extraction in dogs. Surgery 132:424–430

    Article  PubMed  Google Scholar 

  52. Tsukamoto T, Kinoshita H, Hirohashi K et al. (1999) Human erythrocyte polyamine levels after portal vein embolization. Hepatogastroenterology 46:3178–3183

    PubMed  CAS  Google Scholar 

  53. Uesaka K, Nimura Y, Nagino M (1996) Changes in hepatic lobar function after right portal vein embolization. An appraisal by biliary indocyanine green excretion. Ann Surg 223:77–83

    Article  PubMed  CAS  Google Scholar 

  54. Wakabayashi H, Ishimura K, Okano K et al. (2001) Is preoperative portal vein embolization effective in improving prognosis after major hepatic resection in patients with advanced-stage hepatocellular carcinoma? Cancer 92:2384–2390

    Article  PubMed  CAS  Google Scholar 

  55. Wakabayashi H, Yachida S, Maeba T et al. (2002a) Evaluation of liver function for the application of preoperative portal vein embolization on major hepatic resection. Hepatogastroenterology 49:1048–1052

    PubMed  Google Scholar 

  56. Wakabayashi H, Ishimura K, Okano K et al. (2002b) Application of preoperative portal vein embolization before major hepatic resection in patients with normal or abnormal liver parenchyma. Surgery 131:26–33

    Article  PubMed  Google Scholar 

  57. Yamakado K, Takeda K, Nishide Y et al. (1995) Portal vein embolization with steel coils and absolute ethanol: a comparative experimental study with canine liver. Hepatology 22:1812–1818

    Article  PubMed  CAS  Google Scholar 

  58. Yamakado K, Takeda K, Matsumura K et al. (1997) Regeneration of the un-embolized liver parenchyma following portal vein embolization. J Hepatol 27:871–880

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94800, Villejuif Cedex, France

    Alain J. Roche MD (Head of Interventional Radiology Section and Professor) & Dominique Elias MD (Head of Digestive Surgery Section)

Authors
  1. Alain J. Roche MD
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  2. Dominique Elias MD
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Editor information

Editors and Affiliations

  1. Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Jafar Golzarian MD (Professor of Radiology, Department of Radiology) & Shiliang Sun MD (Associate Professor of Radiology) (Professor of Radiology, Department of Radiology) &  (Associate Professor of Radiology)

  2. Departments of Radiology and Surgery, University of Iowa Hospitals and Clinics, Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    M. J. Sharafuddin MD

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© 2006 Springer-Verlag Berlin Heidelberg

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Roche, A.J., Elias, D. (2006). Portal Vein Embolization. In: Golzarian, J., Sun, S., Sharafuddin, M.J. (eds) Vascular Embolotherapy. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-33257-X_13

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  • DOI: https://doi.org/10.1007/3-540-33257-X_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-21491-5

  • Online ISBN: 978-3-540-33257-2

  • eBook Packages: MedicineMedicine (R0)

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