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Efficacy of Portal Vein Embolization with a Procedure of Sheath Injection and Balloon Occlusion with Gelatin Sponge
Authors:Yosuke Nozawa  Hirokazu Ashida  Kenkichi Michimoto  Shunsuke Kisaki  Rui Kano  Hiroya Ojiri  Toru Ikegami
Affiliation:1.Jikei university, JP
Abstract:Introduction:To evaluate the efficacy, safety, and associated complications of a novel and simple approach to portal vein embolization that utilizes sheath injection and balloon occlusion (PVE-SIBO) with gelatin sponge (GS) for the purpose of increasing future liver remnant (FLR) volume.Methods:Between 1 January, 2006, and 31 August, 2020, 20 patients (15 men, 5 women, aged 64.6 ± 10.2 years) diagnosed with hepatobiliary malignancy underwent presurgical PVE-SIBO at our institution via a percutaneous transhepatic approach to the right portal vein and embolization of the portal vein with GS. We evaluated the increased ratio of FLR volume, operation duration, recanalization rate, and complications following this procedure.Results:All procedures were successful and without complications such as subcapsular hematoma, intra-abdominal bleeding, and bile leakage. The increased ratio of FLR volume was 34.7 ± 23.7% after a mean of 14.3 ± 2.57 days, and there was a significant difference in the FLR volume before and after PVE (P < 0.01). Procedure time was 52.7 ± 11.4 minutes.Conclusion:PVE-SIBO with GS is a simple, effective, and safe procedure to increase the ratio of FLR volume prior to hepatic surgeries.
Keywords:future liver remnant   gelatin sponge   hepatic resection   portal vein embolization   balloon occlusion
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