The Effect of TACE Combined with Portal Vein Embolization on the Remaining Liver Volume in Patients with Hepatocellular Carcinoma and Insufficient Remaining Liver Volume

doi:10.3969/j.issn.1004-5775.2025.23.012

Abstract：Objective: To analyze the effect of transcatheter arterial chemoembolization (TACE) combined with portal vein embolization on the changes in remaining liver volume in patients with hepatocellular carcinoma and insufficient remaining liver volume. Methods: A total of 68 patients with hepatocellular carcinoma who were admitted to the Central Hospital of Zhumadian City from May 2019 to February 2021 were selected as the study subjects, all of whom had insufficient remaining liver volume. According to the random number table method, they were divided into a control group (34 cases) and a study group (34 cases). The control group received portal vein embolization, while the study group received TACE combined with portal vein embolization. The differences in treatment effects after 6 months, as well as the levels of total bilirubin, aspartate aminotransferase, and alanine aminotransferase before and 3 days after surgery, and the volumes of non-embolized lobes, total liver volume, and the ratio of non-embolized lobe volume to total liver volume before and at 3 and 6 weeks after surgery were compared between the two groups. Results: In the control group, 10 patients had their disease controlled, accounting for 29.42% of the total patients; in the study group, 18 patients had their disease controlled, accounting for 52.94%, with a statistically significant difference (χ2=3.886, P<0.05). Both groups showed increased levels of total bilirubin, aspartate aminotransferase, and alanine aminotransferase 3 days after surgery compared to pre-surgery, with the study group showing higher levels than the control group, and the differences were statistically significant (t=9.504, 11.509, 12.293, P<0.05). Both groups showed a trend of decreasing then increasing total liver volume 3 and 6 weeks after surgery compared to pre-surgery, but there was no statistically significant difference between the two groups at 3 and 6 weeks post-surgery (t=0.167, 0.279, P>0.05). Both groups showed an increasing trend in non-embolized lobe volume and the ratio of non-embolized lobe volume to total liver volume 3 and 6 weeks after surgery compared to pre-surgery, and the study group showed greater increases than the control group, with statistically significant differences (t=10.897, 13.839, 4.997, 5.358, P<0.05). Conclusion: TACE combined with portal vein embolization shows significant efficacy in patients with hepatocellular carcinoma and insufficient remaining liver volume, which can restore liver function and increase the volume of non-embolized liver, thereby providing surgical opportunities for patients who previously could not undergo surgical resection due to insufficient liver volume.