H. Tsuge et al., RIGHT PORTAL EMBOLIZATION BEFORE EXTENDED RIGHT HEPATECTOMY USING LAPAROSCOPIC CATHETERIZATION OF THE ILEOCOLIC VEIN - A PROSPECTIVE-STUDY, Surgical laparoscopy & endoscopy, 4(4), 1994, pp. 258-263
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.