Portal vein embolization vs. portal vein ligation for induction of hypertrophy of the future liver remnant

The objective of this study was to assess the efficacy of right portal vein embolization (PVE) vs. right portal vein ligation (PVT) for induction of hypertrophy of the left lateral liver lobe before extended right hepatectomy. Thirty-four patients with primary or secondary liver tumors and estimated remnant functional liver parenchyma of less than 0.5% of body weight under-went either right PVE (transcutaneous, n = 10; transileocolic, n = 7) or right PVL (n = 17). Liver volume was assessed by CT scan before occlusion of the right portal vein and prior to resection. There were no deaths. The morbidity rate in each group was 5.8% (PVE, I abscess; PVL, I bile leak). The increase in liver volume was significantly higher after PVE compared with PVL (188 81 ml vs. 123 +/- 58 ml) (P = 0.012). Postoperative hospital stay was significantly shorter after PVT in comparison to PVL (4 2.9 days vs. 8.1 +/- 5.1 days; P < 0.01). Curative liver resection was performed in 10 of 17 patients after PVE and I I of 17 patients after PVL. PVT and PVL were found to be feasible and safe methods of increasing the remnant functional liver volume and achieving resectability for extended liver tumors. PVT results in a significantly more efficient increase in liver volume and a shorter hospital stay. (C) 2002 The Society for Surgery of the Alimentary Tract, Inc.