Concurrent biliary drainage and portal vein embolization in preparation for extended hepatectomy in patients with biliary cancer

摘要

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. To report on a new regime where percutaneous transhepatic biliary drainage (PTBD) and PVE are performed simultaneously, shortening the preoperative process. Six patients were treated with concurrent PTBD and PVE under general anesthesia. 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. The combined approach of PTBD and PVE seems feasible, but more studies on morbidity are warranted.