Luz Jose Hugo M, Gomes Filipe V, Coimbra Elia, Costa Nuno V, Bilhim Tiago
Interventional Radiology Unit, Curry Cabral Hospital CHULC, Rua Beneficencia 8, Zip Code 1069-166, Lisbon, Portugal.
Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
Radiol Res Pract. 2020 Feb 21;2020:9295852. doi: 10.1155/2020/9295852. eCollection 2020.
Liver volume and function after hepatectomies are directly correlated to postoperative complications and mortality. Consequently contemporary liver surgery has focused on reaching an adequate future liver remnant so as to diminish postoperative morbidity and mortality. Portal vein embolization has evolved and is the standard of care as a liver regenerative strategy in many surgery departments worldwide before major liver resections. Different embolic materials have been used for portal vein embolization including gelfoam, ethanol, polyvinyl-alcohol particles, calibrated microspheres, central vascular plugs, coils, n-butyl-cyanoacrylate glue, fibrin glue, polidocanol-foam, alcoholic prolamin solution, and ethylene vinyl alcohol copolymer, as sole occluders or in varied combinations. While to date there has been no prospective controlled trial comparing the efficacy of different embolic materials in portal vein embolization, retrospective data insinuates that the use of n-butyl-cyanoacrylate and absolute ethanol produces higher contralateral liver hypertrophies. In this review, we evaluated publications up to August 2019 to assess the technical and regenerative results of portal vein embolization accomplished with different embolic materials. Special attention was given to specific aspects, advantages, and drawbacks of each embolic agent used for portal vein embolization, its liver regenerative performance, and its influence on patient outcome.
肝切除术后的肝脏体积和功能与术后并发症及死亡率直接相关。因此，当代肝脏手术专注于保留足够的未来肝脏残余量，以降低术后发病率和死亡率。门静脉栓塞术不断发展，在全球许多外科科室中，它已成为主要肝脏切除术前肝脏再生策略的标准治疗方法。门静脉栓塞术使用了不同的栓塞材料，包括明胶海绵、乙醇、聚乙烯醇颗粒、校准微球、中心血管塞、线圈、正丁基氰基丙烯酸酯胶、纤维蛋白胶、聚多卡醇泡沫、醇溶谷蛋白溶液和乙烯-乙烯醇共聚物，可单独作为封堵剂，也可组合使用。尽管迄今为止尚无前瞻性对照试验比较不同栓塞材料在门静脉栓塞术中的疗效，但回顾性数据表明，使用正丁基氰基丙烯酸酯和无水乙醇可使对侧肝脏肥大更明显。在本综述中，我们评估了截至2019年8月的相关文献，以评估使用不同栓塞材料进行门静脉栓塞术的技术和再生效果。我们特别关注了用于门静脉栓塞术的每种栓塞剂的具体方面、优缺点、其肝脏再生性能及其对患者预后的影响。
