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World J Gastrointest Oncol. Nov 15, 2022; 14(11): 2088-2096
Published online Nov 15, 2022. doi: 10.4251/wjgo.v14.i11.2088
Portal vein embolization failure: Current strategies and future perspectives to improve liver hypertrophy before major oncological liver resection
Gianluca Cassese, Ho-Seong Han, Boram Lee, Jai Young Cho, Hae Won Lee, Boris Guiu, Fabrizio Panaro, Roberto Ivan Troisi
Gianluca Cassese, Roberto Ivan Troisi, Clinical Medicine and Surgery, Federico II University, Naples 80131, Italy
Ho-Seong Han, Jai Young Cho, Department of Surgery, Seoul National University College of Medicine, Seongnam 13620, South Korea
Boram Lee, Hae Won Lee, Department of Surgery, Seoul National University Bundang Hospital, Seongnam 13620, South Korea
Boris Guiu, Department of Medical Imaging and Interventional Radiology, St-Eloi University Hospital, Montpellier 34295, France
Fabrizio Panaro, Digestive Surgery and Transplantation, CHU de Montpellier, Montpellier 34295, France
Author contributions: Cassese G, Han HS, Panaro F, and Troisi RI conceived and designed the study; Lee HW, Cho JY, Guiu B, and Troisi RI critically revised the manuscript; Cassese G and Lee B wrote the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ho-Seong Han, MD, PhD, Professor, Department of Surgery, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Seongnam 13620, South Korea.
Received: August 4, 2022
Peer-review started: August 4, 2022
First decision: September 30, 2022
Revised: October 1, 2022
Accepted: October 31, 2022
Article in press: October 31, 2022
Published online: November 15, 2022
Core Tip

Core Tip: Portal vein embolization (PVE) is actually considered the standard of care for inducing volume augmentation of the future remnant liver. However, 20% of patients who have undergone PVE, reportedly never undergo curative resection, due to either insufficient future remnant liver (FRL) growth with an unacceptable risk of post-hepatectomy liver failure, or oncologic progression after PVE, while waiting for the adequate FRL hypertrophy (6-8 wk or more). The management of PVE failure is still highly debated, with different additional techniques that have been proposed, such as sequential transarterial chemoembolization followed by PVE, segment 4 PVE, intra-portal administration of stem cells, dietary supplementation, and hepatic vein embolization.