ASO Author Reflections: Portal Vein Embolization Followed by Hepatectomy for Hepatocellular Carcinoma in Patients with Impaired Liver Function: Is It Justified?

Excerpt

Hepatectomy is a mainstay of curative treatment for hepatocellular carcinoma (HCC); however, impaired liver function due to underlying chronic liver disease often restricts curative treatment options, including hepatectomy. Major hepatectomy can lead to severe postoperative liver failure in patients with an insufficient future liver remnant (FLR). To overcome this concern, portal vein embolization (PVE), first described by Makuuchi et al.,1 has gained support worldwide. PVE induces atrophy of the embolized liver lobe with compensatory hypertrophy of the non-embolized contralateral liver lobe, thereby reducing severe postoperative liver failure in patients with an insufficient FLR.2^,3 However, patients with HCC often have impaired liver function due to underlying chronic liver disease, raising the question of whether the strategy of PVE followed by hepatectomy is properly indicated for those patients. …