J.Jpn. Surg. Soc.. 92(9): 1320-1323, 1991
Report on the annual meeting
PREOPERATIVE PORTAL EMBOLIZATION INCREASES SAFETY OF HEPATECTOMY
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1) Department of Surgery, National Cancer Center Hospital, Tokyo, Japan Tomoo Kosuge1), Masatoshi Makuuchi2), Tadatoshi Takayama1), Kazuaki Shimada1), Junji Yamamoto1), Susumu Yamazaki1), Hiroshi Hasegawa1) |
Between 1983 and 1990, PE was performed in 71 patients (41 with hepatocellular carcinoma (HCC), 8 with other liver tumors, and 22 with biliary carcinoma), in 63 cases to the main branch, prior to hepatectomy. Out of these 63 patients 42 (extended) hemihepatectomies were performed. For comparison 77 patients with the same extent of hepatectomy, but without PE, were studied. Liver volume was evaluated by CT examination.
Portal venous pressure was elevated by 73 mmH2O just after embolization of the main portal branch. However, no complications were associated to the PE procedure except for temporary elevation of transaminases. Volume of the unembolized lobe increased by 8.8% in average following PE. Prominent volume gain was observed in the patients with prior arterial embolization and long observation period. In patients with PE prior to major hepatectomy, postoperative bilirubin values were significantly lower (P＜0.01) . In the group with PE, no fulminant liver failure was seen and no operative mortality was encountered, as compared to 11.7% (9/77) in the control group.
Preoperatively performed PE was a safe procedure decreasing postoperative liver failure and mortality.
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