Double vein embolization before major hepatectomy: A single-center experience.

Background: The volume of the future liver remnant (FLR) must be evaluated before major hepatectomy, particularly right-sided resections. Double vein embolization (DVE) is the preoperative simultaneous embolization of the portal and hepatic veins to induce hypertrophy of the contralateral side. This study aimed to evaluate our institution's experience with DVE.

Methods: Patients who underwent DVE at our institution between 2017 and 2024 were included in the study. The primary outcomes of interest were the safety of DVE, the degree of hypertrophy (DoH), the kinetic growth rate (KGR) of the FLR, and post-surgical complication rate, including 30-day postoperative mortality.

Results: A total of 29 patients who underwent DVE were included in the study. The most common malignancy was colorectal liver metastases. The mean DoH was 10.5% ± 8.3%, and the mean KGR was 5.7% ± 7.0% per week. Of note, 1 patient had a postembolization complication, and 2 patients had inadequate hypertrophy. Of 29 patients, 27 underwent subsequent liver resection. There were 0 intraoperative complications, 8 postoperative complications (Clavien-Dindo class IIIa and IIIb), and 3 mortalities, none of which were due to liver failure after hepatectomy.

Conclusion: Our institution's experience demonstrates that DVE is a safe and effective option to offer patients for augmentation of their FLR before undergoing a major hepatectomy.