Portal vein embolization and cholangiocarcinoma

Preoperative portal vein embolization (PVE) is increasingly used to optimize the volume and function of the future liver remnant (FLR) and to reduce the risk for complications after major hepatectomy for cholangiocarcinoma. In patients with hilarcholangiocarcinoma who are candidates for extended hepatectomy, careful preoperative preparation using biliary drainage, FLRvolumetry, and PVE optimizes the volume and function of the FLR prior to surgery. Appropriate use of PVE has led to improved postoperative outcomes after major hepatectomy for cholangiocarcinoma and oncological outcomes similar to those in patients who undergo resection without PVE. FLRvolumetry is necessary for proper selection of patients for PVE. Analysis of the degree of hypertrophy of the FLR after PVE complements analysis of the pre-PVEFLR volume. FLR degree of hypertrophy and FLR volume are the best predictors of early outcome after major hepatectomy for cholangiocarcinoma