Portal vein embolisation for extended hepatectomy: single-centre experience.

Background: Portal vein embolisation (PVE) induces contra-lateral liver hypertrophy to facilitate an extended hepatectomy.

Aim: This paper aims to analyse our data on PVE and extended hepatectomy. Outcome measures included success of PVE, feasibility of resections, operative morbidity and survival.

Methods: A retrospective analysis of data collected prospectively on 33 patients (2004-2008) was performed. Survival curves were estimated by the Kaplan-Meier (Breslow) method. Significance was defined as p < 0.05.

Results: A total of 31 patients had successful PVE. There were 24 patients who underwent surgery. Significant hypertrophy of residual liver was noted from 230.15 (pre-embolisation) to 428.50 ml (post-embolisation) (median, p < 0.0001). A total of 16 patients had hepatectomy (14: R0; 2: R1) with a single mortality (6.25%) and 56.25% morbidity, and a median length of stay of 17 days. Median overall survival was 14 (95% CI 7.8-20.2) months. Patients who underwent resection had a median disease-specific survival of 33 (95% CI 4-62) months compared with 8.6 (95% CI 0-19.9) months for patients without resection (p = 0.14). For patients with primary hepato-biliary tumours, the median disease-specific survival was 7.9 (95% CI 4.5-11.3) months compared with a median survival of 19.7 (95% CI 0-42.2) months for patients with metastases (p = 0.07).

Conclusions: PVE is safe, facilitates R0 resection and offers the best chance of cure, especially for liver metastases.