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Portal vein embolization: rationale, technique and future prospects
British journal of surgery, 2001-02, Vol.88 (2), p.165-175
Abdalla, E. K.
Hicks, M. E.
Vauthey, J. N.
2001
Details
Autor(en) / Beteiligte
Abdalla, E. K.
Hicks, M. E.
Vauthey, J. N.
Titel
Portal vein embolization: rationale, technique and future prospects
Ist Teil von
British journal of surgery, 2001-02, Vol.88 (2), p.165-175
Ort / Verlag
Oxford, UK: Blackwell Science Ltd
Erscheinungsjahr
2001
Link zum Volltext
Quelle
Wiley Online Library Journals Frontfile Complete
Beschreibungen/Notizen
Background: Advances in surgery have reduced the mortality rate after major liver resection, but complications resulting from inadequate postresection hepatic size and function remain. Portal vein embolization (PVE) was proposed to induce hypertrophy of the anticipated liver remnant in order to reduce such complications. The techniques, measurement methods and indications for this treatment remain controversial. Methods: A Medline search was performed to identify papers reporting the use of PVE before hepatic resection. Techniques, complications and results are reviewed. Results: Complications of PVE typically occur in less than 5 per cent of patients. No specific substance (cyanoacrylate, thrombin, coils or absolute alcohol) emerged as superior. The increase in remnant liver volume averages 12 per cent of the total liver. The morbidity rate of resection after treatment is less than 15 per cent and the mortality rate is 6–7 per cent with cirrhosis and 0–6·5 per cent without cirrhosis. Embolization is currently used for patients with a normal liver when the anticipated liver remnant volume is 25 per cent or less of the total liver volume, and for patients with compromised liver function when the liver remnant volume is 40 per cent or less. Conclusion: This treatment does not increase the risks associated with major liver resection. It may be indicated in selected patients before major resection. Future prospective studies are needed to define more clearly the indications for this evolving technique. © 2001 British Journal of Surgery Society Ltd
Sprache
Englisch
Identifikatoren
ISSN: 0007-1323
eISSN: 1365-2168
DOI: 10.1046/j.1365-2168.2001.01658.x
Titel-ID: cdi_proquest_miscellaneous_70626018
Format
–
Schlagworte
Biological and medical sciences
,
Blood Loss, Surgical - prevention & control
,
Combined Modality Therapy
,
Diseases of the cardiovascular system
,
Embolization, Therapeutic - methods
,
Humans
,
Hypertrophy - prevention & control
,
Liver Diseases - diagnostic imaging
,
Liver Diseases - surgery
,
Liver Diseases - therapy
,
Liver Regeneration
,
Liver, biliary tract, pancreas, portal circulation, spleen
,
Medical sciences
,
Portal Vein
,
Postoperative Complications
,
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
,
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
,
Surgery of the digestive system
,
Survival Analysis
,
Tomography, X-Ray Computed - methods
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