Book contents
- Frontmatter
- Contents
- FOREWORD
- ACKNOWLEDGMENTS
- CONTRIBUTORS
- PART I PRINCIPLES OF ONCOLOGY
- PART II PRINCIPLES OF IMAGE-GUIDED THERAPIES
- PART III ORGAN-SPECIFIC CANCERS
- 9 Hepatocellular Carcinoma: Epidemiology, Pathology, Diagnosis and Screening
- 10 Staging Systems for Hepatocellular Carcinoma
- 11 Hepatocellular Carcinoma: Medical Management
- 12 Surgical Management (Resection)
- 13 Liver Transplantation for Hepatocellular Carcinoma
- 14 Image-guided Ablation of Hepatocellular Carcinoma
- 15 Embolization of Liver Tumors: Anatomy
- 16 Transcatheter Arterial Chemoembolization: Technique and Future Potential
- 17 New Concepts in Targeting and Imaging Liver Cancer
- 18 Intrahepatic Cholangiocarcinoma
- 19 Medical Management of Colorectal Liver Metastasis
- 20 Surgical Resection of Hepatic Metastases
- 21 Clinical Management of Patients with Colorectal Liver Metastasis Using Hepatic Arterial Infusion
- 22 Colorectal Metastases: Ablation
- 23 Colorectal Metastases: Chemoembolization
- 24 Radioembolization with 90Yttrium Microspheres for Colorectal Liver Metastases
- 25 Carcinoid and Related Neuroendocrine Tumors
- 26 Interventional Radiology for the Treatment of Liver Metastases from Neuroendocrine Tumors
- 27 Immunoembolization for Melanoma
- 28 Preoperative Portal Vein Embolization
- 29 Cancer of the Extrahepatic Bile Ducts and the Gallbladder: Surgical Management
- 30 Extrahepatic Biliary Cancer: High Dose Rate Brachytherapy and Photodynamic Therapy
- 31 Extrahepatic Biliary Cancer/Biliary Drainage
- 32 Surgical and Medical Treatment
- 33 Percutaneous Renal Ablation
- 34 Embolotherapy in the Management of Renal Cell Carcinoma
- 35 Epidemiology, Diagnosis, Staging and the Medical-Surgical Management of Lung Cancers
- 36 Image-guided Ablation in the Thorax
- 37 Interventional Treatment Methods for Unresectable Lung Tumors
- 38 Interventional Neuroradiology in Head and Neck Oncology
- 39 Percutaneous Ablation of Painful Metastases Involving Bone
- 40 Intra-arterial Therapy for Sarcomas
- 41 Prostate Cryoablation: A Role for the Radiologist in Treating Prostate Cancer?
- PART IV SPECIALIZED INTERVENTIONAL TECHNIQUES IN CANCER CARE
- INDEX
- Plate section
- References
28 - Preoperative Portal Vein Embolization
from PART III - ORGAN-SPECIFIC CANCERS
Published online by Cambridge University Press: 18 May 2010
- Frontmatter
- Contents
- FOREWORD
- ACKNOWLEDGMENTS
- CONTRIBUTORS
- PART I PRINCIPLES OF ONCOLOGY
- PART II PRINCIPLES OF IMAGE-GUIDED THERAPIES
- PART III ORGAN-SPECIFIC CANCERS
- 9 Hepatocellular Carcinoma: Epidemiology, Pathology, Diagnosis and Screening
- 10 Staging Systems for Hepatocellular Carcinoma
- 11 Hepatocellular Carcinoma: Medical Management
- 12 Surgical Management (Resection)
- 13 Liver Transplantation for Hepatocellular Carcinoma
- 14 Image-guided Ablation of Hepatocellular Carcinoma
- 15 Embolization of Liver Tumors: Anatomy
- 16 Transcatheter Arterial Chemoembolization: Technique and Future Potential
- 17 New Concepts in Targeting and Imaging Liver Cancer
- 18 Intrahepatic Cholangiocarcinoma
- 19 Medical Management of Colorectal Liver Metastasis
- 20 Surgical Resection of Hepatic Metastases
- 21 Clinical Management of Patients with Colorectal Liver Metastasis Using Hepatic Arterial Infusion
- 22 Colorectal Metastases: Ablation
- 23 Colorectal Metastases: Chemoembolization
- 24 Radioembolization with 90Yttrium Microspheres for Colorectal Liver Metastases
- 25 Carcinoid and Related Neuroendocrine Tumors
- 26 Interventional Radiology for the Treatment of Liver Metastases from Neuroendocrine Tumors
- 27 Immunoembolization for Melanoma
- 28 Preoperative Portal Vein Embolization
- 29 Cancer of the Extrahepatic Bile Ducts and the Gallbladder: Surgical Management
- 30 Extrahepatic Biliary Cancer: High Dose Rate Brachytherapy and Photodynamic Therapy
- 31 Extrahepatic Biliary Cancer/Biliary Drainage
- 32 Surgical and Medical Treatment
- 33 Percutaneous Renal Ablation
- 34 Embolotherapy in the Management of Renal Cell Carcinoma
- 35 Epidemiology, Diagnosis, Staging and the Medical-Surgical Management of Lung Cancers
- 36 Image-guided Ablation in the Thorax
- 37 Interventional Treatment Methods for Unresectable Lung Tumors
- 38 Interventional Neuroradiology in Head and Neck Oncology
- 39 Percutaneous Ablation of Painful Metastases Involving Bone
- 40 Intra-arterial Therapy for Sarcomas
- 41 Prostate Cryoablation: A Role for the Radiologist in Treating Prostate Cancer?
- PART IV SPECIALIZED INTERVENTIONAL TECHNIQUES IN CANCER CARE
- INDEX
- Plate section
- References
Summary
With advances in perioperative care, major liver resections are being increasingly performed for primary and metastatic liver tumors. Although fatal liver failure and major technical complications are now rare after resection, complications associated with cholestasis, fluid retention and impaired synthetic function still contribute to protracted recovery time and extended hospital stay (1, 2). Although the risk for perioperative liver failure is multifactorial, one of the most important factors associated with this complication is the volume of the liver remaining after surgery. Patients considered at high risk are those with normal underlying liver in whom more than 80% of the functional liver mass will be removed or those with chronic liver disease who undergo resection of more than 60% of their functional liver mass (2–5).
One strategy used to improve the safety of extensive liver surgery in patients with small remnant livers is preoperative portal vein embolization (PVE) (5–15). PVE redirects portal flow to the intended future liver remnant (FLR) in an attempt to initiate hypertrophy of the non-embolized segments, and PVE has been shown to improve the functional reserve of the FLR before surgery. In appropriately selected patients, PVE can reduce perioperative morbidity and allow for safe, potentially curative hepatectomy for patients previously considered ineligible for resection based on anticipated small remnant livers (5–15). For this patient subset, PVE is now utilized as the standard of care at many comprehensive hepatobiliary centers prior to major hepatectomy.
- Type
- Chapter
- Information
- Interventional OncologyPrinciples and Practice, pp. 316 - 334Publisher: Cambridge University PressPrint publication year: 2008