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L'embolisation portale préopératoire: un moyen efficace pour hypertrophier le foie sain et élargir les indications des résections hépatiques

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DOI: 10.1016/s0001-4001(98)80041-x
  • Tumeurs Du Foie
  • Résection Hépatique
  • Embolisation Portale Préopératoire
  • Liver Tumors
  • Hepatic Resection
  • Preoperative Portal Embolization
  • Medicine


Abstract Aim of the study: The aim of the preoperative portal embolization is a redistribution of the portal venous blood flow in an attempt to induce hypertrophy of the future remnant liver in order to perform a curative liver resection. Material and methods: Preoperative portal embolization was performed in a group of 43 patients. The volumetric ratio (future remnant liver/total liver — tumor) was 20%. Liver metastases were present in 40 patients and primary liver tumor in three. Twenty-four patients had received chemotherapy prior to the preoperative portal embolization. Required operative procedures were right hepatectomy ( n = 15), right hepatectomy extended to the segment IV ( n = 24) or atypical resection ( n = 4). Preoperative portal embolization was performed under percutaneous transhepatic approach with a Blue Histoacryl ® and Lipiodol Ultra Fluide ® mixture. Liver volumetric measurements were obtained with 3D color encoded computed tomography, before portal embolization and before surgery. Results: Hypertrophy of the future remnant liver was 83 ± 58% after a mean 32-day interval between portal embolization and surgery. The tolerance of portal embolization was excellent. Thirty-six hepatectomies were performed as initially planned; seven were cancelled for emergence of metastases (distant in six patients and intrahepatic in one). Conclusion: Pre-operative portal embolization is a safe and effective procedure which increases the possibilities of curative resection in the liver tumors.

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