Major hepatic resection following portal vein embolisation: indications, technique and peri-operative outcome

Murtaza Dar, G., Lawrence, E., Ahmed, S., Pannu, A., Sharma, R., Khan, K. , Jabbar, S. and Mirza, A. (2020) Major hepatic resection following portal vein embolisation: indications, technique and peri-operative outcome. Clinical Oncology and Research, 2(6), (doi: 10.31487/j.COR.2019.06.07)

Abstract

Major liver resections are limited by the volume of future liver (FLR) remnant with the risk of subjecting patient to post surgery liver failure. This increases morbidity and mortality of the patients. However, the technique of ipsilateral portal vein embolisation (PVE) has given surgeons extra mileage to consider major liver resections previously thought to be unresectable. Al cases should be discussed in a multidisciplinary setting. A good knowledge of portal anatomy and variations should be known as part of selection procedure for PVE. Base liver functional status should be reviewed before consideration given to PVE. CT volumetry assessment should be made before and after PVE to assess for resectability. Multiple embolic materials are used in current practice, but none have shown superiority. Several complications are related to application of PVE, however it is generally regarded a safe procedure. At least four weeks are required to assess for FLR with repeat abdominal cross-sectional imaging. Patients with normal liver function tests achieve maximum hypertrophy in four weeks versus patients with underlying liver disease. Liver surgery is scheduled upto 2 to 6 weeks following embolisation. The aim of this article is to provide an overview of current indications, technique, complications and outcomes following PVE.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Khan, Mr Khurram
• Authors: Murtaza Dar, G., Lawrence, E., Ahmed, S., Pannu, A., Sharma, R., Khan, K., Jabbar, S., and Mirza, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Clinical Oncology and Research
• Publisher: Science Repository
• ISSN: 2613-4942
• ISSN (Online): 2613-4942
• Copyright Holders: Copyright © 2019 Ahmad Mirza
• First Published: First published in Clinical Oncology and Research 2(6)
• Publisher Policy: Reproduced under a Creative Commons license