Portal Vein Embolization vs. Portal Vein Ligation for Induction of Hypertrophy of the Future Liver Remnant

2002 ◽  
Vol 6 (6) ◽  
pp. 905-913 ◽  
Author(s):  
D Broering
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Future Liver Remnant ◽  
Portal Vein Ligation ◽  
Liver Remnant ◽  
The Future

scholarly journals Successful Thrombectomy via a Surgically Reopened Umbilical Vein for Extended Portal Vein Thrombosis Caused by Portal Vein Embolization prior to Extended Liver Resection

2020 ◽  
Vol 14 (2) ◽  
pp. 320-328
Author(s):  
Wouter J.M. Derksen ◽  
Iris E.M. de Jong ◽  
Carlijn I. Buis ◽  
Koen M.E.M. Reyntjens ◽  
G. Matthijs Kater ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Portal Vein Embolization ◽  
Liver Surgery ◽  
Umbilical Vein ◽  
Future Liver Remnant ◽  
Main Stem ◽  
Liver Remnant ◽  
Vein Thrombosis ◽  
The Future

Selective portal vein embolization (PVE) before extended liver surgery is an accepted method to stimulate growth of the future liver remnant. Portal vein thrombosis (PVT) of the main stem and the non-targeted branches to the future liver remnant is a rare but major complication of PVE, requiring immediate revascularization. Without revascularization, curative liver surgery is not possible, resulting in a potentially life-threatening situation. We here present a new surgical technique to revascularize the portal vein after PVT by combining a surgical thrombectomy with catheter-based thrombolysis via the surgically reopened umbilical vein. This technique was successfully applied in a patient who developed thrombosis of the portal vein main stem, as well as the left portal vein and its branches to the left lateral segments after selective right-sided PVE in preparation for an extended right hemihepatectomy. The advantage of this technique is the avoidance of an exploration of hepatoduodenal ligament and a venotomy of the portal vein. The minimal surgical trauma facilitates additional intravascular thrombolytic therapy as well as the future right extended hemihepatectomy. We recommend this technique in patients with extensive PVT in which percutaneous less invasive therapies have been proven unsuccessful.

Trans-Splenic Portal Vein Embolization: A Technique to Avoid Damage to the Future Liver Remnant

2016 ◽  
Vol 39 (10) ◽  
pp. 1514-1518 ◽  
Author(s):  
Ammar Sarwar ◽  
Olga R. Brook ◽  
Jeffrey L. Weinstein ◽  
Khalid Khwaja ◽  
Muneeb Ahmed
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
The Future

scholarly journals Predictive Factors for Hypertrophy of the Future Liver Remnant After Portal Vein Embolization: A Systematic Review

2021 ◽  
Author(s):  
E. A. Soykan ◽  
B. M. Aarts ◽  
M. Lopez-Yurda ◽  
K. F. D. Kuhlmann ◽  
J. I. Erdmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Portal Vein ◽  
Portal Vein Embolization ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
The Future ◽  
Quantitative Synthesis ◽  
Neo Adjuvant Chemotherapy ◽  
Meta Analyses ◽  
Subsequent Literature

AbstractThis systematic review was conducted to determine factors that are associated with the degree of hypertrophy of the future liver remnant following portal vein embolization. An extensive search on September 15, 2020, and subsequent literature screening resulted in the inclusion of forty-eight articles with 3368 patients in qualitative analysis, of which 18 studies were included in quantitative synthesis. Meta-analyses based on a limited number of studies showed an increase in hypertrophy response when additional embolization of segment 4 was performed (pooled difference of medians = − 3.47, 95% CI − 5.51 to − 1.43) and the use of N-butyl cyanoacrylate for portal vein embolization induced more hypertrophy than polyvinyl alcohol (pooled standardized mean difference (SMD) = 0.60, 95% CI 0.30 to 0.91). There was no indication of a difference in degree of hypertrophy between patients who received neo-adjuvant chemotherapy and those who did not receive pre-procedural systemic therapy(pooled SMD = − 0.37, 95% CI − 1.35 to 0.61), or between male and female patients (pooled SMD = 0.19, 95% CI − 0.12 to 0.50).The study was registered in the International Prospective Register of Systematic Reviews on April 28, 2020 (CRD42020175708).

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