EFFECT OF PREOPERATIVE PORTAL-VEIN EMBOLIZATION ON MAJOR HEPATECTOMY FOR ADVANCED-STAGE HEPATOCELLULAR CARCINOMAS IN INJURED LIVERS - A PRELIMINARY-REPORT

With the aim of minimizing postoperative liver dysfunction and promoti ng increased resectability, we employed portal vein embolization (PVE) . In this study, the effect of PVE on major hepatic resection for adva nced-stage hepatocellular carcinoma (HCC) in injured livers was evalua ted. PVE was performed prior to hepatectomy in 13 patients with stage III and TV HCCs. Following PVE, right trisegmentectomy was performed i n 3 patients, extended right lobectomy in 3 and right lobectomy in 7. To evaluate the effect of PVE, the changes in liver functional capacit y and estimated remnant liver volume (ERLV), determined by computed to mography, were examined before and after PVE. The operative morbility, mortality, and survival rates after hepatectomy were also assessed. B y 2 weeks after PVE, ERLV had increased in all patients, by an average of 28%, and the mean resection rates had decreased from 70.0% to 62.2 %. Postoperatively, the 30-day mortality rate was 15.3%, and the 1- an d 2-year survival rates were 69% and 46%, respectively. The results of this study indicate that resectability can be increased, and major he patectomy can be made safer by employing PVE preoperatively, in view o f the fact that major hepatectomy was not considered feasible without PVE in these patients.