Abstract
Two 5.5 French triple-lumen balloon catheters were devised to improve percutaneous transhepatic portal embolization (PTPE) as preoperative management of patients undergoing extensive liver resection. Using these catheters, an ipsilateral approach for embolization is achieved through a portal branch of the liver using fibrin glue mixed with Lipiodol as the embolic material. This approach proved safer and more reliable than the traditional contralateral approach: (1) The portal branch to be resected is punctured; (2) the left and right anterior portal embolization is conducted simultaneously through a single portal puncture; and (3) the catheter sheath can consequentially be removed soon after PTPE without requiring further treatment.
Résumé
On présente deux types de cathéter à ballonnet, de 5.5 F, destinés à améliorer l'embolisation porte préopératoire par voie percutanée transhépatique, en vue d'une résection hépatique étendue. Avec ces cathéters, on peut aborder le foie homolatéral à l'embolisation et Femboliser avec une colle à base de fibrine mélangée à du lipiodol. Cette approche semble plus sûre et fiable que l'approche traditionnelle controlatérale, pour les raisons suivantes: ponction du lobe hépatique et du système porte à réséquer, possibilité d'embolisation simultanée des branches portes antérieures, gauche et droite avec une seule ponction et possibilité d'enlever rapidement la gaine du cathéter après l'embolisation.
Resumen
Dos diferentes catéteres de balón de triple lumen fueron diseñados para mejorar la embolización portal transhepática percutánea como manejo postoperatorio en pacientes sometidos a resecciones hepáticas extensas. Con estos catéteres se logra un aproche ipsilateral para la embolización a través de una rama portal del hígado utilizando pegante de fibrina mezclado con Lipiodol como material embólico. Este aproche, que ha demonstrado ser más seguro y confiable que el aproche contralateral tradicional, se realiza así: primero, se punciona la rama portal que va a ser resecada; segundo, se practica la embolización portal anterior izquierda y derecha simultáneamente a través de punción portal única; tercero, la vaina del catéter puede ser removida sin que sea necesario tratamiento adicional alguno.
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Nagino, M., Nimura, Y. & Hayakawa, N. Percutaneous transhepatic portal embolization using newly devised catheters: Preliminary report. World J. Surg. 17, 520–523 (1993). https://doi.org/10.1007/BF01655112
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DOI: https://doi.org/10.1007/BF01655112