Portal vein embolization (PVE) is designed to induce hypertrophy of the future liver remnant (FLR), a critical factor associated with the risk of perioperative failure and death after extensive hepatic resection. PVE involves the selective occlusion of portal vein branches supplying the liver segments intended for resection, diverting blood flow to the non-embolized segments, and promoting their growth. Several studies have demonstrated the efficacy of PVE in increasing the FLR volume, thereby reducing postoperative complications such a post-hepatectomy liver failure. However, challenges such as insufficient contralateral hypertrophy and the optimal timing for surgery post-PVE remain subject of ongoing research. An active area of such research involves portal vein embolization combined with hepatic vein embolization, which may improve the resectability of patients with hepatic malignancy.

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Hepatic Augmentation

  • Jonathan Tefera,
  • David C. Madoff

摘要

Portal vein embolization (PVE) is designed to induce hypertrophy of the future liver remnant (FLR), a critical factor associated with the risk of perioperative failure and death after extensive hepatic resection. PVE involves the selective occlusion of portal vein branches supplying the liver segments intended for resection, diverting blood flow to the non-embolized segments, and promoting their growth. Several studies have demonstrated the efficacy of PVE in increasing the FLR volume, thereby reducing postoperative complications such a post-hepatectomy liver failure. However, challenges such as insufficient contralateral hypertrophy and the optimal timing for surgery post-PVE remain subject of ongoing research. An active area of such research involves portal vein embolization combined with hepatic vein embolization, which may improve the resectability of patients with hepatic malignancy.