Comparison of percutaneous transhepatic portal vein embolization and unilateral portal vein ligation

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:jiangur2
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AIM:To compare the effect of percutaneous transhepatic portal vein embolization(PTPE) and unilateral portal vein ligation(PVL) on hepatic hemodynamics and right hepatic lobe(RHL) atrophy.METHODS:Between March 2005 and March 2009,13 cases were selected for PTPE(n = 9) and PVL(n = 4) in the RHL.The PTPE group included hilar bile duct carcinoma(n = 2),intrahepatic cholangiocarcinoma(n = 2),hepatocellular carcinoma(n = 2) and liver metastasis(n = 3).The PVL group included hepatocellular carcinoma(n = 2) and liver metastasis(n = 2).In addition,observation of postoperative hepatic hemodynamics obtained from computed tomography and Doppler ultrasonography was compared between the two groups.RESULTS:Mean ages in the two groups were 58.9 ± 2.9 years(PVL group) vs 69.7 ± 3.2 years(PTPE group),which was a significant difference(P = 0.0002).Among the indicators of liver function,including serum albumin,serum bilirubin,aspartate aminotransferase,alanine aminotransferase,platelets and indocyanine green retention rate at 15 min,no significant differences were observed between the two groups.Preoperative RHL volumes in the PTPE and PVL groups were estimated to be 804.9 ± 181.1 mL and 813.3 ± 129.7 mL,respectively,with volume rates of 68.9% ± 2.8% and 69.2% ± 4.2%,respectively.There were no significant differences in RHL volumes(P = 0.83) and RHL volume rates(P = 0.94),respectively.At 1 mo after PTPE or PVL,postoperative RHL volumes in the PTPE and PVL groups were estimated to be 638.4 ± 153.6 mL and 749.8 ± 121.9 mL,respectively,with no significant difference(P = 0.14).Postoperative RHL volume rates in the PTPE and PVL groups were estimated to be 54.6% ± 4.2% and 63.7% ± 3.9%,respectively,which was a significant difference(P = 0.0056).At 1 mo after the operation,the liver volume atrophy rate was 14.3% ± 2.3% in the PTPE group and 5.4% ± 1.6% in the PVL group,which was a significant difference(P = 0.0061).CONCLUSION:PTPE is a more effective procedure than PVL because PTPE is able to occlude completely the portal branch throughout the right peripheral vein. AIM: To compare the effect of percutaneous transhepatic portal vein embolization (PTPE) and unilateral portal vein ligation (PVL) on hepatic hemodynamics and right hepatic lobe (RHL) atrophy. METHODS: Between March 2005 and March 2009, 13 cases were selected for PTPE (n = 9) and PVL (n = 4) in the RHL.The PTPE group included hilar bile duct carcinoma (n = 2), intrahepatic cholangiocarcinoma (n = 2), hepatocellular carcinoma = 3). The PVL group included hepatocellular carcinoma (n = 2) and liver metastasis (n = 2). In addition, observation of postoperative hepatic hemodynamics obtained from computed tomography and Doppler ultrasonography was compared between the two groups .RESULTS: Mean ages in the two groups were 58.9 ± 2.9 years (PVL group) vs 69.7 ± 3.2 years (PTPE group), which was a significant difference (P = 0.0002). Amm the indicators of liver function, including serum albumin, serum bilirubin, aspartate aminotransferase , alanine aminotransferase, platelets and indocyanine green retention rate at 15 min, no significant differences were observed between the two groups. Preoperative RHL volumes in the PTPE and PVL groups were estimated to be 804.9 ± 181.1 mL and 813.3 ± 129.7 mL, respectively, with a volume rates of 68.9% ± 2.8 % and 69.2% ± 4.2%, respectively. No significant differences in RHL volumes (P = 0.83) and RHL volume rates (P = 0.94), respectively. At 1 month after PTPE or PVL, postoperative RHL volumes in the PTPE and Postoperative RHL volume rates in the PTPE and PVL groups were estimated to be 54.6% ± 4.2% and 63.7%, respectively, with a significant difference of 638.4 ± 153.6 mL and 749.8 ± 121.9 mL, respectively, with no significant difference (P = 0.14) ± 3% in the PTPE group and 5.4% ± 1.6% in the PVL group, with a significant difference (P = 0.0056) .At 1 mo after the operation, the liver volume atrophy rate was 14.3% ± 2.3% which was a significant difference (P = 0.0061) .CONCLUSION: PTPE is a more effective than PVL because PTP E is able toocclude completely the portal branch throughout the right peripheral vein.
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