Hobson's choice two-stage hepatectomy for multiple and bilobar colorectal liver metastases with portal vein embolization: report of two cases

Surg Today. 2015 Apr;45(4):511-6. doi: 10.1007/s00595-014-0953-x. Epub 2014 Jun 19.

Abstract

Liver resection is recognized as the preferred treatment for patients with colorectal liver metastases (CLM) because it offers long-term survival; it is the only hope for a cure. However, in the majority of cases, liver surgery is contraindicated due to the small volume of the future remnant liver. To extend the surgical indications for CLM, a planned two-stage hepatectomy procedure with portal vein embolization (PVE) was developed specifically for patients with multiple and bilobar CLM. The rationale for performing the procedure was a concern about the possible overgrowth of intrafuture remnant liver lesions following PVE, and it was therefore recommended for all multiple bilobar CLM cases, even when one-stage hepatectomy was technically feasible. We recently performed Hobson's choice two-stage hepatectomy in two cases for reasons different from those of the original planned two-stage hepatectomy. In the present report, we describe our Hobson's choice two-stage hepatectomy strategy, which provided favorable short-term outcomes.

Publication types

  • Case Reports

MeSH terms

  • Cecal Neoplasms / pathology
  • Cecal Neoplasms / surgery
  • Embolization, Therapeutic*
  • Female
  • Hepatectomy / methods*
  • Hepatic Veins / pathology
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Liver Neoplasms / therapy
  • Middle Aged
  • Portal Vein*
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome