Portal vein embolization prior to resection

With improvements in perioperative care, major hepatic resections are increasingly being performed for primary and metastatic hepatobiliary neoplasia. Although fatal hepatic failure and major technical complications are now rare after resection, impaired synthetic function, fluid retention, and cholestasis still contribute to prolonged recovery time and extended hospital stay [1, 2]. Although there are many potential contributing causes for perioperative hepatic failure, volume of the future liver remnant (FLR) constitutes one of the most important risk factors. Patients considered at high risk for perioperative failure are those with chronic liver disease in whom more than 60% of the functional liver mass will be removed or those with normal underlying liver who undergo resection of more than 80% of their functional liver mass [2-5].