Portal vein branches embolization in patients with cholangiocarcinoma: early results

Abstract

The aim — to study the effectiveness of preoperative portal vein embolization (PVE) in patients with cholangiocarcinoma, preparing for radical expanded liver resection (ELR). Materials and methods. PVE was performed in 148 patients with cholangiocarcinoma as fierts step for ELR from 2006 to 2015. Indications for PVE were a future liver remnant (FLR) less than 30 % of total liver volume and a bilirubin level less than 300 mg/l. The change in liver volumes was evaluated by comparsion of CT scans before PVE and before ELR, liver function was assessed with standard laboratory tests. Results and discussion. As a result, PVE managed to achieve a statistically significant increase of FLR by 45.5 %, which made it possible to exclude all patients from high­risk group and to perform ELR in 141 (95.6 %) patients. The dynamics of laboratory tests indicates the processes of cytolysis and a decrease of synthetic liver function that occur after PVE with complete restoration for 3 weeks. Conclusions. PVE allows to increase FLR in patients with cholangiocarcinomas, in the absence of complications, which gives us the right to recommend the inclusion of this technique in the protocol for the preparation of patients with cholangiocarcinomatoexpanded liver resection.