TY - JOUR
T1 - Transhepatic portal vein embolization
T2 - Anatomy, indications, and technical considerations
AU - Madoff, David C.
AU - Hicks, Marshall E.
AU - Vauthey, Jean Nicolas
AU - Charnsangavej, Chusilp
AU - Morello, Frank A.
AU - Ahrar, Kamran
AU - Wallace, Michael J.
AU - Gupta, Sanjay
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - Portal vein embolization (PVE) is increasingly being accepted as a useful procedure in the preoperative treatment of patients selected for major hepatic resection. PVE is performed via either the percutaneous transhepatic or the transileocolic route and is usually reserved for patients whose future liver remnants are too small to allow resection. It is a safe and effective method for inducing selective hepatic hypertrophy of the nondiseased portion of the liver and may thereby reduce complications and shorten hospital stays after resection. A thorough knowledge of hepatic segmentation and portal venous anatomy is essential before performing PVE. In addition, the indications and contraindications for PVE, the methods for assessing hepatic lobar hypertrophy, the means of determining optimal timing of resection, and the possible complications of PVE need to be fully understood before undertaking the procedure. Technique may vary among operators, and further research is necessary to determine the best embolic agents available and the expected rates of liver regeneration for PVE. Nevertheless, as hepatobiliary surgeons become more experienced at performing extended hepatic resections, PVE may be requested more frequently.
AB - Portal vein embolization (PVE) is increasingly being accepted as a useful procedure in the preoperative treatment of patients selected for major hepatic resection. PVE is performed via either the percutaneous transhepatic or the transileocolic route and is usually reserved for patients whose future liver remnants are too small to allow resection. It is a safe and effective method for inducing selective hepatic hypertrophy of the nondiseased portion of the liver and may thereby reduce complications and shorten hospital stays after resection. A thorough knowledge of hepatic segmentation and portal venous anatomy is essential before performing PVE. In addition, the indications and contraindications for PVE, the methods for assessing hepatic lobar hypertrophy, the means of determining optimal timing of resection, and the possible complications of PVE need to be fully understood before undertaking the procedure. Technique may vary among operators, and further research is necessary to determine the best embolic agents available and the expected rates of liver regeneration for PVE. Nevertheless, as hepatobiliary surgeons become more experienced at performing extended hepatic resections, PVE may be requested more frequently.
KW - Liver, anatomy, 761.92
KW - Liver, blood supply, 761.92
KW - Liver, regeneration
KW - Liver, surgery, 761.451
KW - Portal vein, anatomy, 957.92
KW - Portal vein, therapeutic embolization, 957.1264
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U2 - 10.1148/radiographics.22.5.g02se161063
DO - 10.1148/radiographics.22.5.g02se161063
M3 - Article
C2 - 12235336
AN - SCOPUS:0036727567
SN - 0271-5333
VL - 22
SP - 1063
EP - 1076
JO - Radiographics
JF - Radiographics
IS - 5
ER -