Right trisegment portal vein embolization for biliary tract XXXX : technique and clinical utility.

@entity1 @entity1578 @entity991 @entity189
BACKGROUND: Right portal vein embolization has become popular in preparation for right hepatic lobectomy. However, right trisegment portal vein embolization (R3PE) is not well established. METHODS: We performed R3PE in 15 @entity1 with biliary tract @entity189 and 1 @entity1 with @entity991 . We used 2 types of 5.5 F triple-lumen balloon catheters to embolize portal branches of the right trisegment (the left medial, the right anterior, and the right posterior segments). RESULTS: R3PE was successful in all @entity1 without any complications. The calculated volume of the right lobe significantly (P < .01) decreased from 650 +/- 161 cm3 before embolization to 585 +/- 143 cm3 after embolization; the volume of the left lateral segment significantly (P < .0005) increased from 240 +/- 58 cm3 to 361 +/- 66 cm3. The volume of the left medial segment was unchanged. The volume gain of the left lateral segment was larger in @entity1 with R3PE than in those @entity1 (n = 41) with right portal vein embolization (122 +/- 39 cm3 vs 66 +/- 35 cm3; P < .0001). Two of the 16 @entity1 underwent only laparotomy because of peritoneal dissemination, and the remaining 14 @entity1 underwent right hepatic trisegmentectomy with caudate lobectomy. In addition, portal vein resection was also performed in 5 @entity1 , and pancreatoduodenectomy and right hemicolectomy was performed in 3 @entity1 . One @entity1 died of posthepatectomy @entity1578 87 days after surgery, a mortality rate of 7.1% (1/14 @entity1 ). CONCLUSIONS: R3PE is more useful than standard right portal vein embolization in preparation for right hepatic trisegmentectomy and has the potential to increase the safety of this high-risk surgery for @entity1 with biliary tract @entity189 .
