Hepatic hypertrophy and hemodynamics of portal venous flow after percutaneous transhepatic portal embolization

BackgroundPercutaneous transhepatic portal embolization (PTPE) is useful for safe major hepatectomy. This study investigated the correlation between hepatic hypertrophy and hemodynamics of portal venous flow by ultrasound sonography after PTPE.MethodsWe analyzed 58 patients with PTPE, excluding those who underwent recanalization (n=10). Using CT volumetry results 2weeks after PTPE, the patients were stratified into a considerable hypertrophy group (CH; n=15) with an increase rate of remnant liver volume (IR-RLV)40% and a minimal hypertrophy group (MH; n=33) with an IR-RLV<40%. We investigated the hemodynamics of portal venous flow after PTPE and the favorable factors for hepatic hypertrophy.ResultsUnivariate and multivariate analysis identified the indocyanine green retention rate at 15min (ICGR15) and increase rate of portal venous flow volume (IR-pFV) at the non-embolized lobe on day 3 after PTPE as independent favorable factors of IR-RLV. Patients with IR-pFV on day 3 after PTPE 100% and ICGR1515% (n=13) exhibited significantly increased IR-RLV compared with others (n=35).ConclusionsCases with high IR-pFV on day 3 after PTPE exhibited better hepatic hypertrophy. Preserved liver function and increased portal venous flow on day 3 were important.