RIGHT PORTAL EMBOLIZATION BEFORE EXTENDED RIGHT HEPATECTOMY USING LAPAROSCOPIC CATHETERIZATION OF THE ILEOCOLIC VEIN - A PROSPECTIVE-STUDY

Preoperative embolization of the right portal vein branch before exten ded right hepatectomy for hepatocellular carcinoma or hilar cholangioc arcinoma has been recommended for the prevention of postoperative live r failure. Percutaneous transhepatic insertion into the intrahepatic p ortal vein and insertion into the ileocolic vein at open laparotomy ar e used for inserting a catheter introducer into the portal vein. We de vised a new technique for the laparoscopic insertion of a catheter int roducer into the ileocolic vein and used it for right portal embolizat ion in three patients. Measurement of hepatic volume by computed tomog raphy 3 weeks after right portal embolization showed a 28.6 to 66.0% i ncrease in the volume of the predicted remnant liver. This minimally i nvasive procedure has three advantages: reduction of postoperative pai n, avoidance of hepatic injury, and the opportunity for a laparoscopic observation of the liver and the intra-abdominal organs before right portal embolization and hepatectomy.