Preoperative portal vein embolization for hilar cholangiocarcinoma: a report of 16 cases        YI Bin*, XU Ai-min, QÜ Zeng-qiang, et al. *First Department of Biliary ract Diseases, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438,China
Corresponding author: JIANG Xiao-Qing, E-mail:jxq1225@sina.com
Abstract    Objective    To evaluate whether portal vein embolization (PVE) is safe and efficacious in patients with hilar cholangiocarcinoma who are estimated to have inadequate/marginal future liver remnant (FLR). Methods    Between January 2007 and March 2009 at Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University, 16 cases of FLR ratio <50% requiring major hepatectomy underwent PVE with multiple steel coils. Results Sixteen cases (PVE group) were performed PVE resulted from hepatic function injury and FLR ratio <50%. Thirty-three cases (nonPVE group) were performed extended hepatectomy en bloc with the tumor resulted from FLR ratio >50%. PVE complications including bile leak (1/16) and coil displacement (2/16) did not delay hepatectomies. Deficiency of FLR hypertrophy appeared in one case with underlying cirrhosis and prevented him away from surgery. Local tumor progression and peritoneal dissemination precluded hepatectomy in 2 cases. The other 13 cases (81.3%) underwent extended hepatectomy en bloc with the tumor. The PVE hepatectomy group (n=13) had similar complication and mortality rates compared with the non-PVE hepatectomy group (FLR ratio > 50%, n=33) (complication rate, 69.2% vs. 63.6%, P=1.000; mortality rate, 0 vs. 9.1%, P=0.548). Conclusion    PVE is a safe and efficacious procedure in inducing adequate hypertrophy of the FLR before major hepatic resection for hilar cholangiocarcinoma.