Chronic hepatic encephalopathy due to spontaneous splenorenal shunt: successful treatment by transhepatic shunt embolization.

A spontaneous splenorenal shunt, leading to chronic hepatic encephalopathy, was treated by transhepatic occlusion with coils and Enbucrylate. There were no complications. Hepatic encephalopathy subsided.

Multimodal adjuvant treatment and liver transplantation for advanced hepatocellular carcinoma. A pilot study.

Background: Orthotopic liver transplantation has been used in a large number of patients with primary liver cancer because it increases the possibilities of resection of large tumors. Despite isolated cases of prolonged survival, however, the results of liver transplantation for advanced tumors have been universally disappointing because of high rates of tumor recurrence. In an attempt to reduce the recurrence rate, a pilot study testing a multimodal adjuvant treatment in patients undergoing liver replacement for hepatocellular carcinoma was undertaken.

Portal vein embolization: utility for inducing left hepatic lobe hypertrophy before surgery.

Right portal vein embolization (PVE) was performed in patients in need of wide hepatectomy to induce preoperative hypertrophy of the future remnant liver (FRL), which would have been insufficient for safe resection. PVE was achieved with cyanoacrylate or gelatin sponges by using a percutaneous subxiphoid approach in 10 patients with tumors in noncirrhotic liver. Surgery was performed in nine patients 17-48 days (mean, 34 days) after PVE.

[Induction of hypertrophy of a small left hepatic lobe by preoperative right portal embolization, preceding extended right hepatectomy].

The aim of this study was to evaluate the compensatory hypertrophy of the left lobe of the liver, induced by a preoperative right portal embolization (PORPE), and then the feasibility of a right extended hepatectomy. The small size of the left lobe did not initially permit such a resection. Eight patients (mean age: 62 years) underwent PORPE for cancer between September 1987 and December 1991.