de Baere Thierry, Denys Alban, Madoff David C
Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, France.
Tech Vasc Interv Radiol. 2007 Mar;10(1):67-78. doi: 10.1053/j.tvir.2007.08.003.
Preoperative portal vein embolization (PVE) has become an important tool in the management of select patients before major hepatic resection. PVE redirects portal flow to the intended future remnant liver (FRL) to induce hypertrophy of the nondiseased portion of the liver and thereby may reduce complications and shorten hospital stays after surgery. This article reviews the technical considerations for performing PVE including the use of the ipsilateral or contralateral approaches, how to choose a particular embolic agent for PVE, the importance of liver volumetric measurements to estimate functional hepatic reserve, the pathophysiology of PVE, and some of the results showing the benefit of the procedure. In addition, the indications and contraindications for performing PVE in patients with and without chronic liver disease, the use of combination therapies, and the concern for tumor growth after PVE will be discussed.
术前门静脉栓塞术（PVE）已成为大型肝切除术前特定患者管理中的一项重要工具。PVE将门静脉血流重新导向预期的未来残余肝脏（FRL），以诱导肝脏非病变部分肥大，从而可能减少术后并发症并缩短住院时间。本文回顾了进行PVE的技术要点，包括同侧或对侧入路的使用、如何为PVE选择特定的栓塞剂、肝脏体积测量以评估功能性肝储备的重要性、PVE的病理生理学以及一些显示该手术益处的结果。此外，还将讨论在有或无慢性肝病患者中进行PVE的适应证和禁忌证、联合治疗的使用以及对PVE后肿瘤生长的关注。
