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Portal Vein Embolization

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Hilar Cholangiocarcinoma

Abstract

Preoperative portal vein embolization (PVE) is performed to increase the safety of major hepatic resection which reduces the volume of the liver and raises the portal pressure immediately after operation. PVE induces atrophy of the embolized portion of the liver to be resected, with compensatory hypertrophy of the contralateral portion of the future preserved liver remnant. Today, PVE is widely accepted as a standard preoperative procedure for patients with hilar cholangiocarcinoma.

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References

  1. Khan SA, Thomas HC, Davidson BR, et al. Cholangiocarcinoma. Lancet. 2005;366:1303–14.

    Article  PubMed  Google Scholar 

  2. Nimura Y, Kamiya J, Kondo S, et al. Aggressive preoperative management and extended surgery for hilar cholangiocarcinoma: nagoya experience. J Hepatobiliary Pancreat Surg. 2000;7:155–62.

    Article  PubMed  CAS  Google Scholar 

  3. Nagino M, Nimura Y, Kamiya J, et al. Segmental liver resections for hilar cholangiocarcinoma. Hepatogastroenterology. 1998;45:7–13.

    PubMed  CAS  Google Scholar 

  4. Shimada H, Izumi T, Note M, et al. Anterior segmentectomy with caudate lobectomy for hilar cholangiocarcinoma. Hepato­gastroenterology. 1993;40:61–4.

    PubMed  CAS  Google Scholar 

  5. Kawasaki S, Makuuchi M, Miyagawa S, et al. Radical operation after portal embolization for tumor of hilar bile duct. J Am Coll Surg. 1994;178:480–6.

    PubMed  CAS  Google Scholar 

  6. Miyagawa S, Makuuchi M, Kawasaki S. Outcome of extended right hepatectomy after biliary drainage in hilar bile duct cancer. Arch Surg. 1995;130:759–63.

    Article  PubMed  CAS  Google Scholar 

  7. Kawasaki S, Imamura H, Kobayashi A, et al. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization. Ann Surg. 2003;238:84–92.

    PubMed  Google Scholar 

  8. Seyama Y, Kubota K, Sano K, et al. Long-term outcome of extended hemihepatectomy for hilar bile duct cancer with no mortality and high survival rate. Ann Surg. 2003;238:73–83.

    PubMed  Google Scholar 

  9. Hemming AW, Reed AI, Fujita S, et al. Surgical management of hilar cholangiocarcinoma. Ann Surg. 2005;241:693–9; discussion 699–702.

    Article  PubMed  Google Scholar 

  10. Mimura H, Kim H, Ochiai Y, et al. Radical block resection of hepatoduodenal ligament for carcinoma of the bile duct with double catheter bypass for portal circulation. Surg Gynecol Obstet. 1988;167:527–9.

    PubMed  CAS  Google Scholar 

  11. Nimura Y, Hayakawa N, Kamiya J, et al. Hepatopan­creatoduodenectomy for advanced carcinoma of the biliary tract. Hepatogastroenterology. 1991;38:170–5.

    PubMed  CAS  Google Scholar 

  12. Miyagawa S, Makuuchi M, Kawasaki S, et al. Outcome of major hepatectomy with pancreatoduodenectomy for advanced biliary malignancies. World J Surg. 1996;20:77–80.

    Article  PubMed  CAS  Google Scholar 

  13. Makuuchi M, Takayasu K, Takuma T, et al. Preoperative transcatheter embolization of the portal venous branch for patients receiving extended lobectomy due to the bile duct carcinoma. J Jpn Surg Assoc. 1984;45:1558–64.

    Google Scholar 

  14. Makuuchi M, Thai BL, Takayasu K, et al. Preoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report. Surgery. 1990;107:521–7.

    PubMed  CAS  Google Scholar 

  15. Rous P, Larimore LD. Relation of the portal blood to liver maintenance: a demonstration of liver atrophy conditional on compensation. J Exp Med. 1920;31:609–32.

    Article  PubMed  CAS  Google Scholar 

  16. Honjo I, Suzuki T, Ozawa K, et al. Ligation of a branch of the portal vein for carcinoma of the liver. Am J Surg. 1975;130:296–302.

    Article  PubMed  CAS  Google Scholar 

  17. Takayasu K, Muramastu Y, Shima Y, et al. Hepatic lobar atrophy following obstruction of the ipsilateral portal vein from cholangiocarcinoma. Radiology. 1986;160:389–93.

    PubMed  CAS  Google Scholar 

  18. Kawasaki S, Makuuchi M, Kakazu T, et al. Resection for multiple metastatic liver tumors after portal embolization. Surgery. 1994;115:674–7.

    PubMed  CAS  Google Scholar 

  19. Kubota K, Makuuchi M, Kusaka K, et al. Measurement of liver volume and hepatic functional reserve as a guide to decision-making in resectional surgery for hepatic tumors. Hepatology. 1997;26:1176–81.

    PubMed  CAS  Google Scholar 

  20. Nagino M, Nimura Y, Kamiya J, et al. Right or left trisegment portal vein embolization before hepatic trisegmentectomy for hilar bile duct carcinoma. Surgery. 1995;117:677–81.

    Article  PubMed  CAS  Google Scholar 

  21. Nagino M, Kamiya J, Kanai M, et al. Right trisegment portal vein embolization for biliary tract carcinoma: technique and clinical utility. Surgery. 2000;127:155–60.

    Article  PubMed  CAS  Google Scholar 

  22. Madoff DC, Abdalla EK, Gupta S, et al. Transhepatic ipsilateral right portal vein embolization extended to segment IV: improving hypertrophy and resection outcomes with spherical particles and coils. J Vasc Interv Radiol. 2005;16:215–25.

    Article  PubMed  Google Scholar 

  23. Capussotti L, Muratore A, Ferrero A, et al. Extension of right portal vein embolization to segment IV portal branches. Arch Surg. 2005;140:1100–3.

    Article  PubMed  Google Scholar 

  24. Azoulay D, Raccuia JS, Castaing D, et al. Right portal vein embolization in preparation for major hepatic resection. J Am Coll Surg. 1995;181:266–9.

    PubMed  CAS  Google Scholar 

  25. Imamura H, Shimada R, Kubota M, et al. Preoperative portal vein embolization: an audit of 84 patients. Hepatology. 1999;29:1099–105.

    Article  PubMed  CAS  Google Scholar 

  26. De Baere T, Roche A, Elias D, et al. Preoperative portal vein embolization for extension of hepatectomy indications. Hepatology. 1996;24:1386–91.

    Article  PubMed  Google Scholar 

  27. Kinoshita H, Sakai K, Hirohashi K, et al. Preoperative portal vein embolization for hepatocellular carcinoma. World J Surg. 1986;10:803–8.

    Article  PubMed  CAS  Google Scholar 

  28. Di Stefano DR, de Baere T, Denys A, et al. Preoperative percutaneous portal vein embolization: evaluation of adverse events in 188 patients. Radiology. 2005;234:625–30.

    Article  PubMed  Google Scholar 

  29. Nagino M, Nimura Y, Kamiya J, et al. Selective percutaneous transhepatic embolization of the portal vein in preparation for extensive liver resection: the ipsilateral approach. Radiology. 1996;200:559–63.

    PubMed  CAS  Google Scholar 

  30. Nagino M, Nimura Y, Kamiya J, et al. Changes in hepatic lobe volume in biliary tract cancer patients after right portal vein embolizaiton. Hepatology. 1995;21:434–9.

    PubMed  CAS  Google Scholar 

  31. Abdalla EK, Barnett CC, Doherty D. Extended hepatectomy in patients with hepatobiliary malignancies with and without ­preoperative portal vein embolization. Arch Surg. 2002;137:675–81.

    Article  PubMed  Google Scholar 

  32. Madoff DC, Hicks ME, Abdalla EK, et al. 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. 2003;227:251–60.

    Article  PubMed  Google Scholar 

  33. Shimamura T, Nakajima Y, Une Y, et al. Efficacy and safety of preoperative percutaneous transhepatic portal embolization with absolute ethanol: a clinical study. Surgery. 1997;121:135–41.

    Article  PubMed  CAS  Google Scholar 

  34. Elias D, Ouellet JF, De Baere T, et al. Preoperative selective portal vein embolization before hepatectomy for liver metastases: long-term results and impact on survival. Surgery. 2002;131:294–9.

    Article  PubMed  Google Scholar 

  35. Denys AL, Abehsera M, Leloutre B, et al. Intrahepatic hemodynamic changes following portal vein embolization: a prospective Doppler study. Eur Radiol. 2000;10:1703–7.

    Article  PubMed  CAS  Google Scholar 

  36. Takayama T, Makuuchi M, Kosuge T, et al. Preoperative portal embolization. Ann Ital Chir. 1997;68:745–50.

    PubMed  CAS  Google Scholar 

  37. Aoki T, Imamura H, Hasegawa K, et al. Sequential preoperative arterial and portal venous embolizations in patients with hepatocellular carcinoma. Arch Surg. 2004;139:766–74.

    Article  PubMed  Google Scholar 

  38. Goto Y, Nagino M, Nimura Y. Doppler estimation of portal blood flow after percutaneous transhepatic portal vein embolization. Ann Surg. 1998;228:209–13.

    Article  PubMed  CAS  Google Scholar 

  39. Lee KC, Kinoshita H, Hirohashi K, et al. Extension of surgical indications for hepatocellular carcinoma by portal vein embolization. World J Surg. 1993;17:109–15.

    Article  PubMed  CAS  Google Scholar 

  40. Yamakado K, Takeda K, Matsumura K, et al. Regeneration of the un-embolized liver parenchyma following portal vein embolization. J Hepatol. 1997;27:871–80.

    Article  PubMed  CAS  Google Scholar 

  41. Kokudo N, Tada K, Seki M, et al. Proliferative activity of intrahepatic colorectal metastases after preoperative hemihepatic portal vein embolization. Hepatology. 2001;34:267–72.

    Article  PubMed  CAS  Google Scholar 

  42. Harada H, Imamura H, Miyagawa S, et al. Fate of the human liver after hemihepatic portal vein embolization: cell kinetic and morphometric study. Hepatology. 1997;26:1162–70.

    PubMed  CAS  Google Scholar 

  43. Kusaka K, Imamura H, Tomiya T, et al. Expression of transforming growth factor-alpha and -beta in hepatic lobes after hemihepatic portal vein embolization. Dig Dis Sci. 2006;51:1404–12.

    Article  PubMed  CAS  Google Scholar 

  44. Shimada R, Imamura H, Nakayama, et al. Changes in blood flow and function of the liver after right portal vein embolization. Arch Surg. 2002;137:1384–8.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  46. Nishiguchi S, Shiomi S, Sasaki N, et al. Course before and after percutaneous transhepatic portal vein embolization of a patient with cholangiocarcinoma monitored by schintigraphy with Tc-99m galactosyl human serum albumin. Ann Nucl Med. 2000;14:231–4.

    Article  PubMed  CAS  Google Scholar 

  47. Hirai I, Kimura W, Fuse A, et al. Evaluation of preoperative portal vein embolization for safe hepatectomy, with special reference to assessment of nonembolized lobe function with 99mTc-GSA SPECT scintigraphy. Surgery. 2003;133:495–506.

    Article  PubMed  Google Scholar 

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Correspondence to M. Makuuchi MD, PhD .

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© 2013 Springer Science+Business Media Dordrecht and People's Medical Publishing House

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Hashimoto, T., Makuuchi, M. (2013). Portal Vein Embolization. In: Lau, W. (eds) Hilar Cholangiocarcinoma. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6473-6_14

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  • DOI: https://doi.org/10.1007/978-94-007-6473-6_14

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  • Print ISBN: 978-94-007-6472-9

  • Online ISBN: 978-94-007-6473-6

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