Benefit of percutaneous transhepatic portal vein embolization for extended hepatectomy

: Severely locally advanced biliary cancer requires extended hepatectomy in many cases. Percutaneous transhepatic portal vein embolization (PTPE) is effective to expand the residual liver volume and to avoid postoperative hepatic failure. The ratios of increase in the expected residual liver volume after PTPE are about 10% in cases with right lobar or right trisegment embolization and about 7% in cases with left trisegment embolization. After the introduction of the PTPE technique in our department, the morbidity rate from hepatic failure and mortality rate decreased from 33.3% to 23.8% and from 21.9% to 9.5%, respectively. The technique of PTPE has contributed to an improved survival rate for patients with severely advanced biliary cancer.