Portal Vein Embolization for Contralateral Liver Hypertrophy. The liver is functionally divided into anatomical left and right lobes based on their relationship to the main trunk of the portal vein. For patients with right lobe tumors, surgical removal of this lobe, or right hepatic lobectomy, may be the best course of action.
And segments remain after surgery called the Future Remnant Liver, or FRL, is too small to support the body, pre-operative corrections must be made. In such cases, Portal Vein Embolization, or PVE, offers a minimally invasive procedure that enlarges the FRL by utilizing the liver's natural regenerative ability. For this procedure, the portal vein Is accessed by a direct course through the liver with the needle and guide wire to protect the sheath. Using sonagraphic and flouroscopic guidance, a catheter is advanced to each portal branch to be resected. Embolization is then performed through medical-grade radiopaque glue, which sets immediately, clogging the blood flow into the vessel. This is repeated for each branch until complete declusion is achieved. This procedure is well tolerated although some patients may experience mild discomfort or slight fever for the first three days.
Over a period of four to six weeks, patients with healthy groom livers will experience contralateral liver hypertrophy and approximated 70% increase in FRL volume, afterwards where its patients may be eligible for surgery and further regeneration may be expected.
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