Radical operation after portal embolization for tumor of hilar bile duct.

The clinical outcomes of patients with carcinoma of the proximal bile duct who underwent portal embolization of the right lobe followed by right extended lobectomy with (n = 3) and without (n = 9) pancreatoduodenectomy, are described. Preoperative embolization of the portal venous branch of the right hepatic lobe, which was performed with the intent of preventing postoperative hepatic failure, induced a significant increase in the volume of the future remnant liver (left lobe) (from 437 +/- 88 to 544 +/- 97 milliliters, p < 0.01). No patients died in the hospital after the resectional operation. One patient, who had poorly differentiated adenocarcinoma, died as a result of tumor recurrence 12 months after operation, and in another patient, distant lymph node metastases were found. The remaining ten patients are alive and well with no signs of recurrence. The three who underwent hepatopancreatoduodenectomy are leading a normal life 14, 21 and 22 months postoperatively.