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.
Highlights
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
Though the mixture of GS used in our study was slightly viscous, it was smoothly injected through the gap between the sheath and catheter in the Portal vein embolization (PVE)-SIBO procedure
Sheath size varied from 6- to 8-French depending on the type of balloon catheter, but this caused no difficulty in injection
Summary
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. Many reports have described the efficacy and safety of PVE using various institutiondependent PVE techniques and embolic materials, such as absolute ethanol, n-butyl-2-cyanoacrylate (NBCA), ethanolamine oleate (EOI), coil, polyvinyl alcohol (PVA), and gelatin sponge (GS) [3]. These methods and materials have their limitations. We believe few reports describe the use, safety, efficacy, and associated complications of this method; we undertook a retrospective evaluation of these considerations in our patients
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