Clinical Study Of Portal Vein Embolization Inducing Compensatory Hypertrophy Of The Remnant Liver

OBJECTIVE:To evaluate the feasibility,safety and effectiveness of portal vein embolization(PVE) inducing compensatory hypertrophy of the remnant liver in clinical use.METHODS: PVE was performed in 20 patients who were unresectable advanced hepatocellular carcinoma ones with gelfoam,absolute alcohol and coils embolic agents.Right portal vein was embolized with percutaneous transhepatic or percutaneous transplenic approach through the fluoroscopic guidance.Left hepatic lobe volume was measured with computed tomographic scans abtained before and after PVE.Portal venous pressure,ALT(alanine aminotransferase),AST(aspartate aminotransferase),TBIL(total bilirubin) and PT(prothrombin time) were measured before and after PVE.The results were analyzed with statistics to evaluate the safety and effectiveness of PVE. RESULTS:Right portal vein was embolized successfully in all patients.Right liver resection was performed in 1 patient. The left hepatic lobe volume was (461.5±108.2)cm3 before PVE,and (608.5±135.7) cm3,(660.2±133.8) cm3,(678.0±132.7) cm3 2 weeks,4 weeks,8 weeks after PVE respectively.Left hepatic lobe volume increased (33.5±22.1)%,(45.4±23.8)%,(49.5±24.0)% respectively.The percent of left hepatic lobe volume in total hepatic volume was (18.4±5.1)%,(24.2±5.9)%,(26.3±5.8)%,(27.0±6.1)% before and 2 weeks,4 weeks,8 weeks after PVE respectively. Portal vein hypertension did not take place after PVE in all patiets.Liver function damage after PVE was slight.It recovered normal level in one week.No complication happened after PVE in all patients.CONCLUSIONS:It is feasible,safe and effective that PVE induce compensatory hypertrophy of the remnant liver in clinical use.