Abstract

Portal vein embolization (PVE) if often used before major hepatectomy to increase the volume of the future liver remnant (FLR) and thus prevent postsurgical liver failure. In this chapter, the history, methods, efficacy, and limitations of PVE are summarized, and a potential breakthrough in the limitations of PVE is described. PVE was introduced in 1982 in the case of a patient with cholangiocarcinoma. Since its introduction, the indications for preoperative PVE have extended to hepatocellular carcinoma, gallbladder carcinoma, and colorectal liver metastasis, and PVE is now considered an indispensable ancillary procedure performed to ensure the safety of major hepatectomy. There are two main PVE techniques, representing two approaches to PVE: transileocolic portal vein embolization (TIPE) and percutaneous transhepatic portal vein embolization (PTPE). Various embolic materials can be used to occlude the portal branches that will be resected.

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