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Dealing with an insufficient future liver remnant: Portal vein embolization and two‐stage hepatectomy
Author(s) -
Kawaguchi Yoshikuni,
Lillemoe Heather A.,
Vauthey JeanNicolas
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25430
Subject(s) - medicine , portal vein embolization , hepatectomy , stage (stratigraphy) , embolization , portal vein , resection , surgery , chemotherapy , vein , radiology , general surgery , paleontology , biology
Colorectal liver metastases (CLM) are not always resectable at the time of diagnosis. An insufficient future liver remnant is a factor excluding patients from curative intent resection. To deal with this issue, two‐stage hepatectomy was introduced approximately 20 years ago. It is a sequential treatment strategy for bilateral CLM, which consists of preoperative chemotherapy, portal vein embolization, and planned first and second liver resections. This study reviews current evidence supporting use of two‐stage hepatectomy.