The role of portal vein embolization prior to hepatic resection for primary and secondary hepatic malignancies

Hepatic resection is the potential curative therapy for select hepatic malignancies, but inadequate future liver remnant (FLR) following resection may limit the performance of adequate surgical resection. As a result, portal vein embolization (PVE) has been developed to induce hypertrophy in the FLR to facilitate safe hepatic resection. Here, we performed a systematic review of the literature to provide an outline and summary of the current status of PVE and to identify current developments and controversies regarding its application in hepatic surgery. Although data from randomized controlled trials may be lacking, current reports indicate safe and effective application of PVE. However, a consensus on standard technique and appropriate patient selection has not been established. Furthermore, the potential effects of PVE on tumor growth and proliferation remain to be fully elucidated. Nevertheless, PVE appears to be a safe technique that effectively decreases the risk of fulminant hepatic failure in patients requiring major hepatic resection. Future studies are necessary to address appropriate patient selection for this technique and its optimal role in the multidisciplinary management of hepatic malignancies.