Portal Vein Embolization With N-Butyl-Cyanoacrylate Through an Ipsilateral Approach Before Major Hepatectomy: Single Center Analysis of 50 Consecutive Patients

• Autor(a) principal: Mendes Luz, JH
• Data de Publicação: 2017
• Outros Autores: Mendes Luz, P, Bilhim, T, Martin, H, Gouveia, H, Coimbra, E, Veloso Gomes, F, Souza, R, Faria, I, Nepomuceno de Miranda, T
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/2778
• topic: HCC IMA; CHLC CHBPT; Combined Modality Therapy; Embolization, Therapeutic/methods; Enbucrilate/administration & dosage; Hepatectomy/methods; Liver Neoplasms/therapy; Portal Vein; Treatment Outcome

PURPOSE: To evaluate the efficacy of portal vein embolization (PVE) with n-Butyl-cyanoacrylate (NBCA) through an ipsilateral approach before major hepatectomy. Secondary end-points were PVE safety, liver resection and patient outcome. METHODS: Over a 5-year period 50 non-cirrhotic consecutive patients were included with primary or secondary liver cancer treatable by hepatectomy with a liver remnant (FLR) volume less than 25% or less than 40% in diseased livers. RESULTS: There were 37 men and 13 women with a mean age of 57 years. Colorectal liver metastases were the most frequent tumor and patients were previously exposed to chemotherapy. FLR increased from 422 ml to 629 ml (P < 0.001) after PVE, corresponding to anincrease of 52%. The FLR ratio increased from 29.6% to 42.3% (P < 0.001). Kinetic growth rate was 2.98%/week. A negative association was observed between increase in the FLR and FLR ratio and FLR volume before PVE (P = 0.002). In 31 patients hepatectomy was accomplished and only one patient presented with liver insufficiency within 30 days after surgery. CONCLUSIONS: PVE with NBCA through an ipsilateral puncture is effective before major hepatectomy. Meticulous attention is needed especially near the end of the embolization procedure to avoid complications.