Sequential embolization of the branches of the bile duct and portal vein to the targeted hepatic lob

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BACKGROUND:?The?high?recurrence?rate?of?hepatolithiasis?and?the?high?operative?risk?of?right?posterior,?caudate?or?multiple? lobe? hepatectomy? are? the? unsettled? problems? in?hepatobiliary?surgery.?The?present?study?was?to?investigate?the?efifcacy?of?chemical?hepatectomy?performed?via?applying?sequential?embolization?of?the?branches?of?the?bile?duct?and?portal?vein?to?the?targeted?hepatic?lobe. METHODS:?The?bile?duct?and?portal?vein?branches?of?the?median?hepatic?lobe?of?rats?were?treated?with:?1)?bile?duct?embolization? followed? by? portal? vein? ligation? (BDE+PVL)?and?2)?portal?vein?ligation?followed?by?bile?duct?embolization?(PVL+BDE).?The?efifcacy?of?chemical?hepatectomy?in?BDE+PVL?and?PVL+BDE?groups?was?compared?with?that?of?sole?BDE?by?histology?and?Western?blotting?analysis?of?collagen?I?expression. RESULTS:?After?six?weeks?of?the?chemical?hepatectomy,?rats?in?the?BDE?group?showed?hepatocyte?damages,?ifbrosis?and?"self-cut"?only?in?the?periphery?of?the?embolized?lobe.?In?contrast,?rats?in?the?PVL+BDE?and?BDE+PVL?groups?exhibited?complete?necrosis? of? hepatocytes? and? replacement? with? proliferative?ductules?and?collagen?ifbers,?leading?to?complete?ifbrosis?and?"self-cut"?phenomenon?in?the?whole?targeted?lobe.?Collagen?I?expression?in?the?PVL+BDE?group?was?slightly?higher?than?that?in?the?BDE+PVL?group;?however,?no?statistically?signiifcant?difference?was?noted. CONCLUSION:?The?sequential?embolization?of?the?bile?duct?and?portal?vein?branches?to?the?targeted?hepatic?lobe?may?be?a?feasible?and?effective?approach?to?acheive?the?ideal?effect?of?chemical?hepatectomy?in?a?short?period?of?time.
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