Portal vein embolization

Devasted
Devasted Member Posts: 185
edited March 2014 in Colorectal Cancer #1
Does anyone have any experience with preop portal vein embolization? My husband is scheduled for this procedure in a couple weeks. Any advice or experiences would be appreciated.
Thanks

Comments

  • ADKer
    ADKer Member Posts: 147
    #2
    PVE
    I had the procedure done prior to my liver resection. I needed to have my entire right lobe and the 2 middle lobes removed, leaving only the 2 left lateral lobes and the bottom caudate lobe. The PVE was done on the right lobes to cause my left lobes to hypertrophy - grow larger - prior to the liver resection. The PVE was necessary because such a large portion of my liver had to be removed. It worked well and I was able to have the liver resection 5 weeks later. The PVE itself required only an overnight hospital stay. The only concern I would raise is that I had my procedures done at MSKCC where the PVE is done by an interventional radiologist. The anesthesia used is supposed to be conscious sedation. However, I was totally awake for the entire procedure and was very uncomfortable. I have had 2 children and childbirth is worse but PVE is the second most painful thing that I have gone through while conscious. Insist on talking to the anesthesiologist and make sure that you are on the same page.
  • banma
    banma Member Posts: 9
    #3
    ADKer said:

    PVE
    I had the procedure done prior to my liver resection. I needed to have my entire right lobe and the 2 middle lobes removed, leaving only the 2 left lateral lobes and the bottom caudate lobe. The PVE was done on the right lobes to cause my left lobes to hypertrophy - grow larger - prior to the liver resection. The PVE was necessary because such a large portion of my liver had to be removed. It worked well and I was able to have the liver resection 5 weeks later. The PVE itself required only an overnight hospital stay. The only concern I would raise is that I had my procedures done at MSKCC where the PVE is done by an interventional radiologist. The anesthesia used is supposed to be conscious sedation. However, I was totally awake for the entire procedure and was very uncomfortable. I have had 2 children and childbirth is worse but PVE is the second most painful thing that I have gone through while conscious. Insist on talking to the anesthesiologist and make sure that you are on the same page.

    PVE
    I had a PVE, too. I agree with ADKer that you do not want to be wide awake for the entire thing. I was only awake toward the end & I did not enjoy it, though for me on a pain scale of 1- 10 it was probably only a 5 or 6.

    I had a round of chemo after the PVE and before the surgery -- I think it helped control the cancer in the "good" part of the liver. The intraoperative ultrasound during the liver resection will show if any new mets have developed (or become visible.) The process of hypertrophy sends a lot of blood into the future remnant liver & it's important to keep it clear, so I'd encourage a round of chemo if it is appropriate in your circumstances. Something to ask your medical team about anyway.

    The PVE also has the beneficial effect of allowing your liver a "headstart" on recovering from the liver resection. 4-6 weeks later the liver has done a lot of hard work adjusting to the changes in blood flow in & out of the liver -- this helps decrease the chance for unwanted complications.

    All in all it's a safe, smart, helpful thing to do. My surgeon swears by them.

    Good luck.

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