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PORTAL VEIN EMBOLIZATION WITH N-BUTYL-CYANOACRYLATE THROUGH AN IPSILATERAL APPROACH BEFORE MAJOR HEPATECTOMY: SINGLE CENTER ANALYSIS OF 50 CONSECUTIVE PATIENTS
Embolization
Future liver remnant
Extended hepatectomy
Hepatic Insufficiency
Autor
Afiliación
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Department of Interventional Radiology, Centro Hepato-Bilio-Pancreático e de Transplantação.Hospital Curry Cabral, CHLC, Lisbon, Portugal
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Department of Interventional Radiology, Centro Hepato-Bilio-Pancreático e de Transplantação.Hospital Curry Cabral, CHLC, Lisbon, Portugal
Department of Interventional Radiology, Centro Hepato-Bilio-Pancreático e de Transplantação.Hospital Curry Cabral, CHLC, Lisbon, Portugal
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Department of Interventional Radiology, Centro Hepato-Bilio-Pancreático e de Transplantação.Hospital Curry Cabral, CHLC, Lisbon, Portugal
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Department of Interventional Radiology, Centro Hepato-Bilio-Pancreático e de Transplantação.Hospital Curry Cabral, CHLC, Lisbon, Portugal
Department of Interventional Radiology, Centro Hepato-Bilio-Pancreático e de Transplantação.Hospital Curry Cabral, CHLC, Lisbon, Portugal
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Department of Interventional Radiology, Radiology Division, National Cancer Institute, INCA, Rio de Janeiro, Brazil
Resumen en ingles
Purpose: To evaluate the efficacy of portal vein embolization (PVE) with n-Butyl-cyanoacrylate (NBCA) through
an ipsilateral approach before major hepatectomy. Secondary end-points were PVE safety, liver resection and
patient outcome. Methods: Over a 5-year period 50 non-cirrhotic consecutive patients were included with primary or secondary liver cancer treatable by hepatectomy with a liver remnant (FLR) volume less than 25% or less than 40% in diseased livers. Results: There were 37 men and 13 women with a mean age of 57 years. Colorectal liver metastases were the most frequent tumor and patients were previously exposed to chemotherapy. FLR increased from 422 ml to 629 ml (P < 0.001) after PVE, corresponding to anincrease of 52%. The FLR ratio increased from 29.6% to 42.3% (P < 0.001). Kinetic growth rate was 2.98%/week. A negative association was observed between increase in the FLR and FLR ratio and FLR volume before PVE (P = 0.002). In 31 patients hepatectomy was accomplished and only one patient presented with liver insufficiency within 30 days after surgery. Conclusions: PVE with NBCA through an ipsilateral puncture is effective before major hepatectomy. Meticulous attention is needed especially near the end of the embolization procedure to avoid complications.
Palabras clave en ingles
Portal VeinEmbolization
Future liver remnant
Extended hepatectomy
Hepatic Insufficiency
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