Ces radiol. 2014, 68(2):113-119

Portal vein embolization prior extended right hepatectomy using poly(2-hydroxyethyl methacrylate)Original article

Jan H. Peregrin1, Jozef Kováč1, Dana Kautznerová1, Eva Honsová3, Martin Oliverius2, Martin Köcher4, Marie Černá4, Vlastimil Válek5, Tomáš Andrašina5, Martin Přádný6, Jiří Michálek6
1 Oddělení diagnostické a intervenční radiologie IKEM, Praha
2 Oddělení transplantační chirurgie IKEM, Praha
3 Oddělení klinické a transplantační patologie IKEM, Praha
4 Klinika radiologie FN, Olomouc
5 Klinika radiologie FN, Brno-Bohunice
6 Ústav makromolekulární chemie AV ČR, v.v.i., Praha

Aim: Primary aim is to find out if PHEMA (2-hydroxymethacrylate) is suitable for embolization of right liver lobe portal vein in patients indicated for extensive right lobe hepatectomy. Secondary aim is to compare two methods of liver volume estimation: standard liver CT volume calculation and liver volume estimation according to body surface area.

Method: Embolization of right liver lobe using PHEMA was performed at three different hospitals in total of 22 patients. Embolization was done from transhepatic approach by retrograde portal vein catheterization. After average 39.7 (10-120) days a hypertrophy of left liver lobe was measured. Left liver lobe posthypertrophic volume was compared to total liver volume calculated by two ways - one from CT volumetry, the other one estimated from body surface area.

Results: Technical success was achieved in all procedures; right liver lobe portal vein was occluded in all cases. In 14 patients the volume of left liver lobe increased at least by five percent or more of the total liver volume. We did not experience any complication connected to embolization material property or to the way the embolization was performed. Total liver volumes estimated by two methods differ notably especially in extremely small or big liver.

Conclusion: PHEMA proved to be suitable material for portal vein embolization in patients indicated to extended right lobe hepatectomy with predicted too small remnant liver volume postoperatively. Both methods recommended for calculation of liver volume could be used, but the results could differ significantly.

Keywords: extended right hepatectomy, portal vein embolization, embolization iduced left liver lobe hypertrophy
Grants and funding:

Práce byla podporována grantem IGA NT 11273-4/2010.

Accepted: April 10, 2014; Published: June 1, 2014  Show citation

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Peregrin JH, Kováč J, Kautznerová D, Honsová E, Oliverius M, Köcher M, et al.. Portal vein embolization prior extended right hepatectomy using poly(2-hydroxyethyl methacrylate). Ces radiol. 2014;68(2):113-119.
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