Kubo Hidemasa, Saiga Atsushi, Sato Rui, Otsuka Shimpei, Ashida Ryo, Ohgi Katsuhisa, Yamada Mihoko, Kato Yoshiyasu, Uesaka Katsuhiko, Notsu Akifumi, Sugiura Teiichi, Aramaki Takeshi
Division of Interventional Radiology, Shizuoka Cancer Center, Japan.
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Japan.
Interv Radiol (Higashimatsuyama). 2025 Jul 23;10:e20240044. doi: 10.22575/interventionalradiology.2024-0044. eCollection 2025.
Standard methods for percutaneous transhepatic portal vein embolization have not yet been established. This study aimed to elucidate the effectiveness of balloon occlusion in percutaneous transhepatic portal vein embolization using gelatin sponges on the hypertrophy ratio of the future liver remnant volume.
This retrospective study included 93 patients who underwent percutaneous transhepatic portal vein embolization for right hepatectomy between January 2018 and September 2022. Based on the embolization procedure, patients were divided into a balloon group (n = 13) and a non-balloon group (n = 80). The clinical factors and future liver remnant volume hypertrophy ratios were compared. Moreover, significant factors associated with the future liver remnant volume hypertrophy ratio between the groups were analyzed.
The future liver remnant volume hypertrophy ratio was significantly higher in the balloon group than in the non-balloon group (1.44 [interquartile range, 1.37-1.89] vs. 1.29 [1.15-1.46], p = 0.011). The initial future liver remnant volume (289 [interquartile range, 259-454] vs. 400 [324-479] mL, p = 0.036) and number of gelatin sponge sheets (5 [interquartile range, 5-6] vs. 4 [3-5], p = 0.008) significantly differed. However, recanalization and severe complications were not different between groups. According to the multivariate linear regression analysis, diabetes mellitus (coefficient, -0.202, p = 0.009), initial future liver remnant volume (coefficient, -0.001, p < 0.001), and balloon occlusion (coefficient, 0.228, p = 0.007) were independent factors affecting the future liver remnant volume hypertrophy ratio.
Balloon occlusion may be effective in future liver remnant volume hypertrophy in percutaneous transhepatic portal vein embolization using gelatin sponges.
经皮肝门静脉栓塞术的标准方法尚未确立。本研究旨在阐明在经皮肝门静脉栓塞术中使用明胶海绵进行球囊闭塞对未来肝残余体积肥大率的有效性。
本回顾性研究纳入了2018年1月至2022年9月期间因右半肝切除术接受经皮肝门静脉栓塞术的93例患者。根据栓塞程序，将患者分为球囊组（n = 13）和非球囊组（n = 80）。比较两组的临床因素和未来肝残余体积肥大率。此外，分析了两组之间与未来肝残余体积肥大率相关的显著因素。
球囊组的未来肝残余体积肥大率显著高于非球囊组（1.44[四分位间距，1.37 - 1.89]对1.29[1.15 - 1.46]，p = 0.011）。初始未来肝残余体积（289[四分位间距，259 - 454]对400[324 - 479]mL，p = 0.036）和明胶海绵片数（5[四分位间距，5 - 6]对4[3 - 5]，p = 0.008）有显著差异。然而，两组之间的再通和严重并发症并无差异。根据多变量线性回归分析，糖尿病（系数，-0.202，p = 0.009）、初始未来肝残余体积（系数，-0.001，p < 0.001）和球囊闭塞（系数，0.228，p = 0.007）是影响未来肝残余体积肥大率的独立因素。
在使用明胶海绵的经皮肝门静脉栓塞术中，球囊闭塞可能对未来肝残余体积肥大有效。
