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Liver surgery underwent enormous evolution after development and introduction of new technical skills in surgical praxis. Nevertheless many patients with primary or secondary liver malignancies are not indicated to radical surgical therapy that could reach complete remission of malignant disease because the frontiers of liver surgery are limited today by the functional reserves of remnant parenchyma. The main argument to non surgical treatment is increased risk of acute liver failure after extended liver resection, where retained liver parenchyma is to small to sustain the liver functions (Abdalla, 2001). Portal vein embolization (PVE) can multiply the future liver remnant volume (FLRV) in spite of affection of only one of liver lobes by malignant diseases (Makuuchi, 1984, Makuuchi, 1990, Harada, 1997). This procedure was performed firstly in 1984 by Makuuchi (Abdalla, 2001, Makuuchi, 1984, Makuuchi, 1990). PVE of portal branch of with malignancy afflicted liver lobe initiates compensatory hypertrophy of contralateral non-occluded lobe. The occluded lobe underlies atrophy. The compensatory hypertrophy is supposed to be stimulated by increased flow of portal blood, that contains hepatotrophic substances (Kusaka, 2004, Azoulay, 2000). Liver resection after PVE is performed only in 63-96% of patients (Kokudo, 200, Stefano, 2005, Lagasse, 2000). The main reason for this resolution is unsuccessful hypertrophy of FLRV or progression of malignancy. Liver resection after PVE is performed only in 63-96% of patients (Azoulay, 200, Kokudo, 2001, Stefano, 2005). The main reason for this resolution are unsuccessful hypertrophy of FLRV or progression of malignancy. |
