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Semin intervent Radiol 2008; 25(2): 146-154
DOI: 10.1055/s-2008-1076683
© Thieme Medical Publishers

Sequential Transcatheter Arterial Chemoembolization and Portal Vein Embolization for Hepatocellular Carcinoma: The University of Tokyo Experience

Hiroshi Imamura1 , Yasuji Seyama1 , Masatoshi Makuuchi2 , Norihiro Kokudo1
  • 1Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
  • 2Department of Hepato-Biliary-Pancreatic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
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Publication History

Publication Date:
30 May 2008 (online)

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ABSTRACT

When undertaking portal vein embolization (PVE) in patients with hepatocellular carcinoma (HCC), the following possibilities should be considered: (1) failure to induce hypertrophy of the nonembolized segments due to the underlying liver disease, (2) acceleration of tumor growth by occlusion of the portal venous flow because HCC is a hypervascular tumor fed exclusively by hepatic arterial flow, and (3) poor efficacy of PVE due to the presence of arterioportal shunts frequently observed in cases of liver cirrhosis and HCC. With these in mind, we performed sequential transcatheter arterial chemoembolization (TACE) and PVE in 45 patients with HCC undergoing major liver resection. This double preparation was well tolerated, enhanced the hypertrophy process in the nonembolized segments, and suppressed the tumor growth during the preparation period. Furthermore, PVE also functioned as a preoperative test to select patients for major liver resection. Sequential TACE and PVE is an effective preoperative intervention in patients with HCC scheduled for major liver resection.

KEYWORDS

Portal vein embolization - hepatocellular carcinoma - transcatheter arterial chemoembolization - liver resection

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Hiroshi ImamuraM.D. 

Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Graduate School of Medicine

University of Tokyo, Tokyo, Japan

Email: himamura-tky@umin.ac.jp

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