Document Detail


Use of double-occlusion balloon catheter: preoperative portal vein embolization for induction of future remnant liver hypertrophy.
MedLine Citation:
PMID:  15109222     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the efficacy and safety of using double-occlusion balloon catheters in preoperative portal vein embolization (PVE) to induce future remnant liver hypertrophy. MATERIALS AND METHODS: PVE was achieved with gelatin sponges by using double-occlusion balloon catheter in seventeen patients with hepatobiliary malignant tumors. The ipsilateral approach was used in thirteen patients and the contralateral approach in four patients due to large size of tumor in the right hepatic lobe. Surgery was performed in 15 patients, 14-27 days (mean, 21.9 days) after PVE. Computed tomographic liver volumetric studies were performed before embolization and before surgery. The changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), prothrombin time (PT), and total bilirubin levels before and after the PVE were evaluated. Complications were evaluated after PVE. RESULTS: PVE using double-occlusion balloon catheter was successful in all cases, irrespective of approach technique. The future remnant liver (FRL) volumes were 251-920 cm3 (mean, 437 cm3) before PVE and 281-1042 cm3 (mean, 555 cm3) after PVE. The mean increase in the volume of the FRL was 28.6%; this represented 37% of the preresection volume of the liver. Clinical and biologic tolerance of PVE was mandatory. There were no complications. CONCLUSIONS: PVE using the double-occlusion balloon catheter is safe and well-tolerated and can be performed technically with ease. This hypertrophy allows hepatectomy to be performed safely when the FRL volume is initially insufficient in patients with hepatobiliary tumors.
Authors:
Min Joo Kim; Sung Wook Choo; Young Soo Do; Kwang Bo Park; Yoon Hee Han; In Wook Choo; Jae Min Cho; Jae Won Cho; Sung Joo Kim; Tae Sung Sohn
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  27     ISSN:  0174-1551     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    2004 Jan-Feb
Date Detail:
Created Date:  2004-04-27     Completed Date:  2004-11-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  16-20     Citation Subset:  IM    
Affiliation:
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Alanine Transaminase / blood
Aspartate Aminotransferases / blood
Balloon Occlusion / instrumentation*
Bile Duct Neoplasms / therapy
Biological Markers / blood
Carcinoma, Hepatocellular / therapy
Catheters, Indwelling*
Cholangiocarcinoma / therapy
Equipment Design
Female
Hepatic Duct, Common / pathology
Humans
Hypertrophy / therapy
Klatskin's Tumor / therapy
Liver / blood supply,  pathology,  surgery
Liver Neoplasms / therapy
Male
Middle Aged
Portal Vein / surgery
Prothrombin Time
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase

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