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portal vein embolization

Portal Vein embolization for increasing healthy liver tissue volume


The liver is the largest organ in the body and is located in the right upper abdomen, behind the ribs. This organ consists of two main sections called left and right lobes, with the right lobe being larger than the left lobe. 
Blood is supplied to the liver through to large arteries called portal and hepatic arteries. The liver is an important organ with a variety of functions. 

Liver cancer

Liver cancer is the out-of-control growth of malignant cells in the liver. Liver cancer may be initially originated from abnormal liver cells or bile duct cells or caused by the spread of another organs cancer to the liver (metastasis). 
The most common metastases to the liver are cancers of the rectum, colon, lung, breast, pancreas, esophagus, and skin (malignant melanoma). 
Liver cancer may occur in all ages but it is more common in men over 60. 

Common symptoms
Anorexia and weight loss 
Painful lesion in the right upper abdomen
Pain in the upper abdomen 
Mild fever, usually below 38ºC
Yellowing of eyes and skin 
Abdominal swelling due to fluid aggregation 


The cause of this cancer is unknown. This cancer is more common in a population with a high incidence of viral hepatitis and other chronic liver diseases.
After performing the cancer diagnosis process, the doctor examines different treatment options. Different treatments of the liver cancer are based on the type of cancer and its prevalence.
Primary liver cancer in early stages and some secondary tumors can be controlled and somewhat treated through the following methods. 
Most recently, a new treatment method, i.e. portal vein embolization method, is developed for increasing healthy liver tissue volume. 

Tumor Surgery 

Rdio-frequency of Tumor 

Cryotherapy Tumor Ablation

Embolization of Tumor Artery 

Liver Lobectomy 

Liver Transplant 

General Chemotherapy 


And most recently a new treatment method for increasing the volume of healthy tissue of the liver, portal vein embolization

Treatment priorities

The first suggestion for treatment is surgery and the removal of the entire tumor, which is the best option, if applicable. If surgery is impossible, various methods are recommended, such as heating surgery (ablation of lesion with radio-frequency waves), cryosurgery (cryoablation), general chemotherapy, local chemotherapy (embolization), radiotherapy, alcohol injection, of radiation therapy of cyberknife tumor. 
In some cases, the entire liver may be removed and a liver may be transplanted. In more advances cases, chemotherapy along with some other treatments will be recommended, that will achieve better results. 

Portal vein embolization for increasing healthy liver tissue volume

Liver function in the human body is possible when 30% of liver tissue is healthy. If there is any tumor of liver metastases in either (left of right) lobes, this method can be used for treatment. That is, first, the liver healthy lobe volume will me measured by CT scan. If the healthy tissue volume is less that 30% of the total volume of the liver, portal vein embolization will be performed for blocking the vein i the involved (metastatic) lobe. This surgery increases blood flow in the healthy lobe tissue and, finally, after 4 to 6 weeks, enlarges the volume tissue of the healthy lobe. 
To verify this point, repeated CT scan and evaluation of the healthy liver tissue volume will be required. After re-evaluation, the patient will be prepared for lobectomy surgery. This method is very effective in the treatment and control of cancer. 

Portal vein embolization procedure 

After imaging and running the required tests, portal vein will be determined first under the guidance of imaging devices and a special needle will be directly inserted into the liver vein through the skin. 
After the placement of the needle in the right place, a combination of blockers will be injected into the vein. 
This procedure will lead to portal vein obstruction and a lack of blood supply and eventually shrinks the defective tissue and enlarges the healthy tissue in the front lobe. All these measures are taken to prepare the liver for lobectomy of metastatic tissue. 

Please note that:

To do this surgery, the patient should be monitored by the surgeon (of cancer or gastrointestinal tract) so that the surgery would be performed immediately after the embolization. 

Preparations for performing embolization 

CT scan for assessing liver volume 
Running liver function tests 
Running blood coagulation test 
Having the previous medical records (CT scan, MRI, etc.) 
Pre-operative fasting for 6 hours 
Taking a bath and shaving the right groin 
Having a companion for doing the paperwork 


This surgery is usually performed on an outpatient basis and the patient will be discharged 3 to 4 hourd after the operation. Sometimes the patient may require hospitalization for 24 hours, according to his/her condition and at the doctors discretion. 

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