Effectiveness of Balloon Occlusion in Percutaneous Transhepatic Portal Vein Embolization with Gelatin Sponge: A Single-institutional Retrospective Study.

PURPOSE

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.

MATERIAL AND METHODS

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.

RESULTS

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.

CONCLUSIONS

Balloon occlusion may be effective in future liver remnant volume hypertrophy in percutaneous transhepatic portal vein embolization using gelatin sponges.