The role of portal vein embolization in the surgical management of primary hepatobiliary cancers. A systematic review

Abstract Background Primary liver and biliary cancers are very aggressive tumors. Surgical treatment is the main option for cure or long term survival. The main purpose of this systematic review is to underline the indications for portal vein embolization(PVE), in patients with inadequate future liver remnant(FLR) and to analyze other parameters such as resection rate, morbidity, mortality, survival after PVE and hepatectomy for primary hepatobiliary tumors. Also the role of trans-arterial chemoembolization (TACE) before PVE, is investigated. Methods A systematic search of the literature was performed in Pub Med and the Cochrane Library from 01.01.1990 to 30.09.2015. Results 40 articles were selected, including 2144 patients with a median age of 61 years. The median excision rate was 90% for hepatocellular carcinomas(HCCs) and 86% for hilar cholangiocarcinomas(HCs). The main indications for PVE in patients with HCC and presence of liver fibrosis or cirrhosis was FLR < 40 % when liver function was good (ICGR15