Sometimes the surgeon needs to remove so much of the liver that the remaining portion may not be able to function normally. In this case, you may have a portal vein embolisation (PVE) about 4–8 weeks before the surgery.
The portal vein carries blood from the stomach to the liver, dividing into left and right branches as it enters the liver. PVE involves blocking the branch of the portal vein that carries blood to the part of the liver that is going to be removed. This redirects the blood to the remaining part of the liver to help it grow.
PVE is performed by an interventional radiologist after discussion with the liver surgeon and is normally done under general anaesthetic. The radiologist will insert a tube through the skin into the portal vein using an ultrasound and x-ray as a guide. An x-ray dye is injected to identify the portal vein, and then the targeted branch will be blocked using tiny plastic beads, soft gelatine sponges or metal coils.
A CT scan will be performed before and after the procedure to measure the size of your liver and help your doctor work out whether surgery is possible.