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Concurrent biliary drainage and portal vein embolization in preparation for extended hepatectomy in patients with biliary cancer.
Acta Radiologica Open 2015 May
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.
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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