Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 21, 2012; 18(19): 2371-2376
Published online May 21, 2012. doi: 10.3748/wjg.v18.i19.2371
Comparison of percutaneous transhepatic portal vein embolization and unilateral portal vein ligation
Hiroya Iida, Tsukasa Aihara, Shinichi Ikuta, Hidenori Yoshie, Naoki Yamanaka
Hiroya Iida, Tsukasa Aihara, Shinichi Ikuta, Hidenori Yoshie, Naoki Yamanaka, Department of Surgery, Meiwa Hospital 4-31 Agenaruo-cho, Nisinomiya, Hyogo 663-8186, Japan
Author contributions: Iida H and Yamanaka N designed the research; Iida H, Aihara T, Ikuta S and Yoshie H performed the research; Iida H and Yamanaka N analyzed the data.
Correspondence to: Hiroya Iida, MD, Department of Surgery, Meiwa Hospital 4-31 Agenaruo-cho, Nisinomiya, Hyogo 663-8186, Japan. hiroya0001@mac.com
Telephone: +81-798-471767 Fax: +81-798-477613
Received: June 15, 2011
Revised: November 28, 2011
Accepted: December 31, 2011
Published online: May 21, 2012
Abstract

AIM: To compare the effect of percutaneous transhepatic portal vein embolization (PTPE) and unilateral portal vein ligation (PVL) on hepatic hemodynamics and right hepatic lobe (RHL) atrophy.

METHODS: Between March 2005 and March 2009, 13 cases were selected for PTPE (n = 9) and PVL (n = 4) in the RHL. The PTPE group included hilar bile duct carcinoma (n = 2), intrahepatic cholangiocarcinoma (n = 2), hepatocellular carcinoma (n = 2) and liver metastasis (n = 3). The PVL group included hepatocellular carcinoma (n = 2) and liver metastasis (n = 2). In addition, observation of postoperative hepatic hemodynamics obtained from computed tomography and Doppler ultrasonography was compared between the two groups.

RESULTS: Mean ages in the two groups were 58.9 ± 2.9 years (PVL group) vs 69.7 ± 3.2 years (PTPE group), which was a significant difference (P = 0.0002). Among the indicators of liver function, including serum albumin, serum bilirubin, aspartate aminotransferase, alanine aminotransferase, platelets and indocyanine green retention rate at 15 min, no significant differences were observed between the two groups. Preoperative RHL volumes in the PTPE and PVL groups were estimated to be 804.9 ± 181.1 mL and 813.3 ± 129.7 mL, respectively, with volume rates of 68.9% ± 2.8% and 69.2% ± 4.2%, respectively. There were no significant differences in RHL volumes (P = 0.83) and RHL volume rates (P = 0.94), respectively. At 1 mo after PTPE or PVL, postoperative RHL volumes in the PTPE and PVL groups were estimated to be 638.4 ± 153.6 mL and 749.8 ± 121.9 mL, respectively, with no significant difference (P = 0.14). Postoperative RHL volume rates in the PTPE and PVL groups were estimated to be 54.6% ± 4.2% and 63.7% ± 3.9%, respectively, which was a significant difference (P = 0.0056). At 1 mo after the operation, the liver volume atrophy rate was 14.3% ± 2.3% in the PTPE group and 5.4% ± 1.6% in the PVL group, which was a significant difference (P = 0.0061).

CONCLUSION: PTPE is a more effective procedure than PVL because PTPE is able to occlude completely the portal branch throughout the right peripheral vein.

Keywords: Percutaneous transhepatic portal vein embolization; Portal vein ligation; Liver atrophy; Future liver remnant; Two-stage hepatectomy