Concurrent biliary drainage and portal vein embolization in preparation for extended hepatectomy in patients with biliary cancer

BACKGROUND: Patients with perihilar cholangiocarcinoma and gallbladder cancer extending into the hilum often present with jaundice and a small future liver remnant (FLR). If resectable, preoperative biliary drainage and portal vein embolization (PVE) are indicated. Classically, these measures have b...

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Detalles Bibliográficos
Autores principales: Nilsson, Jan, Eriksson, Sam, Nørgaard Larsen, Peter, Keussen, Inger, Christiansen Frevert, Susanne, Lindell, Gert, Sturesson, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2015
Materias:
Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4433626/
https://www.ncbi.nlm.nih.gov/pubmed/25992300
http://dx.doi.org/10.1177/2058460115579121
Descripción
Sumario:BACKGROUND: Patients with perihilar cholangiocarcinoma and gallbladder cancer extending into the hilum often present with jaundice and a small future liver remnant (FLR). If resectable, preoperative biliary drainage and portal vein embolization (PVE) are indicated. Classically, these measures have been performed sequentially, separated by 4–6 weeks. PURPOSE: To report on a new regime where percutaneous transhepatic biliary drainage (PTBD) and PVE are performed simultaneously, shortening the preoperative process. MATERIAL AND METHODS: Six patients were treated with concurrent PTBD and PVE under general anesthesia. RESULTS: Surgical exploration followed the combined procedure after 35 days (range, 28–51 days). The FLR ratio increased from 22% to 32%. Three patients developed cholangitis after the procedure. CONCLUSION: The combined approach of PTBD and PVE seems feasible, but more studies on morbidity are warranted.

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