Portal Vein Embolisation

PVEfLR is an appropriate preoperative strategy for selected patients with initially unresectable CRLM and can produce long-term survival comparable to ALPPS. Among patients selected for PVE, approximately 80% subsequently undergo liver resection and sufficient liver enlargement is achieved in 96.1% of cases. PVEfLR overall survival is significantly lower than liver transplantation in high tumour load patients. Post-procedure hospital stay is significantly shorter after PVE than after portal vein ligation. PVEfLR has higher postoperative complication rates than liver resection without PVE. PVEfLR has significantly lower postoperative complication rates than ALPPS. PVE redirects portal blood flow toward the remaining healthy liver, stimulating compensatory hypertrophy. Portal vein embolisation blocks blood flow to the tumour-containing portion of the liver by injecting embolic material into portal vein branches. Embolic materials used in PVE include gel foam, ethanol, and polyvinyl-alcohol particles. A notable proportion of patients selected for PVEfLR do not proceed to resection due to inadequate hypertrophy or disease progression, with dropout as high as 28% in one study.