Percutaneous ipsilateral portal vein embolization using histoacryl glue: changing LR, resectibility rate and complications

Background: Liver resection has been the main strategy for treating either primary or secondary liver cancer. However, major liver resection may lead to postoperative liver failure. Portal vein embolization (PVE) is a procedure to induce hypertrophy of a liver remnant (LR) before major resection surgery. There are many variations in procedural techniques, with different advantages and disadvantages.

Objective: We studied change in liver remnant volume, resectibility rate, and complications after percutaneous ipsilateral portal vein embolization (PVE) using histoacryl glue.

Methods: Clinical data of 25 patients who underwent ipsilateral PVE were reviewed. Eighteen patients who had pre- and post- CT studies had total liver volumes (TLV) and LR volumes determined before and after the procedure using MDCT volumetry. Complications and respectability rates were recorded.

Results: All 18 patients who had pre-CT and post-CT studies had increased LR volumes. The mean of LR volumes before and after ipsilateral PVE were calculated at about 449 ml and 586 ml, which were statistically significant (p <0.001). The mean enlargement of LR was 30% (range 4 to 120%). There were no deaths or serious complications. The resectabilty rate was 76%.

Conclusion: Percutaneous transhepatic ipsilateral PVE could increase the LR volumes before major hepatic resection. There were no significant complications in our study group.