Abstract
Portal vein embolization (PVE) may be viewed as a tool used to improve the morbidity and mortality following major hepatectomy. While it is considered relatively safe, PVE is a complex procedure with potential complications. Adverse events may relate to the access approach or to the embolization procedure itself. Given that PVE is neither tumor-reductive nor does it guarantee hepatectomy, its technical and clinical success requires strict patient selection and careful pre-procedure planning. The aim of this chapter is to review the etiology, clinical presentation, and management of complications associated with this procedure.
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References
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(5):521-527.
Abdalla EK, Barnett CC, Doherty D, Curley SA, Vauthey JN. Extended hepatectomy in patients with hepatobiliary malignancies with and without preoperative portal vein embolization. Arch Surg. 2002;137(6):675-680. discussion 680–681.
Abdalla EK, Hicks ME, Vauthey JN. Portal vein embolization: rationale, technique and future prospects. Br J Surg. 2001;88(2):165-175.
Azoulay D, Castaing D, Smail A, et al. Resection of nonresectable liver metastases from colorectal cancer after percutaneous portal vein embolization. Ann Surg. 2000;231(4):480-486.
Madoff DC, Abdalla EK, Vauthey JN. Portal vein embolization in preparation for major hepatic resection: evolution of a new standard of care. J Vasc Interv Radiol. 2005;16(6):779-790.
de Baere T, Roche A, Elias D, Lasser P, Lagrange C, Bousson V. Preoperative portal vein embolization for extension of hepatectomy indications. Hepatology. 1996;24(6):1386-1391.
Denys A, Bize P, Demartines N, Deschamps F, De Baere T. Quality improvement for portal vein embolization. Cardiovasc Intervent Radiol. 2010;33:452-456.
Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg. 2008;247(1):49-57.
Di Stefano DR, de Baere T, Denys A, et al. Preoperative percutaneous portal vein embolization: evaluation of adverse events in 188 patients. Radiology. 2005;234:625-630.
Kodama Y, Shimizu T, Endo H, Miyamoto N, Miyasaka K. Complications of percutaneous transhepatic portal vein embolization. J Vasc Interv Radiol. 2002;13:1233-1237.
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(2 Pt 1):215-225.
Madoff DC, Hicks ME, Abdalla EK, Morris JS, Vauthey JN. 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(1):251-260.
Madoff DC, Hicks ME, Vauthey JN, et al. Transhepatic portal vein embolization: anatomy, indications, and technical considerations. Radiographics. 2002;22(5):1063-1076.
Kinoshita H, Sakai K, Hirohashi K, Igawa S, Yamasaki O, Kubo S. Preoperative portal vein embolization for hepatocellular carcinoma. World J Surg. 1986;10(5):803-808.
Perarnau JM, Daradkeh S, Johann M, Deneuville M, Weinling P, Coniel C. Transjugular preoperative portal embolization (TJPE) a pilot study. Hepatogastroenterology. 2003;50(51):610-613.
Shimura T, Suehiro T, Suzuki H, Okada K, Araki K, Kuwano H. Trans-ileocecal portal vein embolization as a preoperative treatment for right trisegmentectomy with caudate lobectomy. J Surg Oncol. 2007;96(5):438-441.
Wicherts DA, de Haas RJ, Andreani P, et al. Impact of portal vein embolization on long-term survival of patients with primarily unresectable colorectal liver metastases. Br J Surg. 2010;97(2):240-250.
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(2):135-141.
Imamura H, Shimada R, Kubota M, et al. Preoperative portal vein embolization: an audit of 84 patients. Hepatology. 1999;29(4):1099-1105.
Belghiti J, Ogata S. Preoperative optimization of the liver for resection in patients with hilar cholangiocarcinoma. HPB. 2005;7:252-253.
Fujii Y, Shimada H, Endo I, et al. Risk factors of posthepatectomy liver failure after portal vein embolization. J Hepatobiliary Pancreat Sur. 2003;10:226-232.
Chapman WC, Doyle MB, Stuart JE, et al. Outcomes of neoadjuvant transarterial chemoembolization to downstage hepatocellular carcinoma before liver transplantation. Ann Surg. 2008;248:617-625.
Nagino M, Kanai M, Morioka A, et al. Portal and arterial embolization before extensive liver resection in patients with markedly poor functional reserve. J Vasc Interv Radiol. 2000;11:1063-1068.
Lainas P, Boudechiche L, Osorio A, et al. Liver regeneration and recanalization time course following reversible portal vein embolization. J Hepatol. 2008;49:354-362.
Kang BK, Kim JH, Kim KM, et al. Transcatheter arterial chemoembolization for hepatocellular carcinoma after attempted portal vein embolization in 25 patients. Am J Roentgenol. 2009;193(5):W446-W451.
Ogata S, Belghiti J, Farges O, Varma D, Sibert A, Vilgrain V. Sequential arterial and portal vein embolizations before right hepatectomy in patients with cirrhosis and hepatocellular carcinoma. Br J Surg. 2006;93(9):1091-1098.
Kishi Y, Madoff DC, Abdalla EK, et al. Is embolization of segment 4 portal veins before extended right hepatectomy justified? Surgery. 2008;144(5):744-751.
Bruix J, Castells A, Bosch J, et al. Surgical resection of hepatocellular carcinoma in cirrhotic patients: prognostic value of preoperative portal pressure. Gastroenterology. 1996;111(4):1018-1022.
Farges O, Malassagne B, Flejou JF, Balzan S, Sauvanet A, Belghiti J. Risk of major liver resection in patients with underlying chronic liver disease: a reappraisal. Ann Surg. 1999;229:210-215.
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Kodama, Y., Shaw, C.M., Madoff, D.C. (2011). Complications of Portal Vein Embolization. In: Madoff, D., Makuuchi, M., Nagino, M., Vauthey, JN. (eds) Venous Embolization of the Liver. Springer, London. https://doi.org/10.1007/978-1-84882-122-4_18
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DOI: https://doi.org/10.1007/978-1-84882-122-4_18
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