Effectiveness of balloon occlusion in percutaneous transhepatic portal vein embolization with gelatin sponge: a single-institutional retrospective study

Background Standard methods for percutaneous transhepatic portal vein embolization (PTPE) have not yet been established. This study aimed to elucidate the effectiveness of balloon occlusion in PTPE using gelatin sponges on the future liver remnant volume hypertrophy ratio. This retrospective study included 93 patients who underwent PTPE for right hepatectomy between January 2018 and September 2022. Based on the embolization procedure, patients were divided into balloon group (n = 13) and non-balloon group (n = 80). The clinical factors and the future liver remnant volume hypertrophy ratios were compared. Moreover, significant factors associated with the future liver remnant volume hypertrophy ratio between the groups were analyzed. Results The future liver remnant volume hypertrophy ratio was significantly higher in the balloon group than in the non-balloon group (1.44 [interquartile range, 1.37–1.89] vs. 1.29 [1.15–1.46], P  = 0.011). The initial future liver remnant volume (289 [interquartile range, 259–454] vs. 400 [324–479] mL, P  = 0.036) and number of gelatin sponge sheets (5 [interquartile range, 5–6] vs. 4 [3–5], P  = 0.008) significantly differed. However, recanalization and severe complications were not different between groups. According to the multivariate linear regression analysis, diabetes mellitus (coefficient, -0.202; P  = 0.009), initial future liver remnant volume (coefficient, -0.001; P  < 0.001), and balloon occlusion (coefficient, 0.228; P  = 0.007) were independent factors affecting the future liver remnant volume hypertrophy ratio. Conclusion Balloon occlusion may be effective in future liver remnant volume hypertrophy in PTPE using gelatin sponges.