Portal vein embolization (PVE) before major hepatectomy for colorectal liver metastases is indicated when the future liver remnant (FLR) volume falls below which threshold in a non-cirrhotic liver?

• A Less than 25% of total liver volume ✓
• B Less than 50% of total liver volume
• C Less than 40% of total liver volume
• D Less than 10% of total liver volume

Explanation

In patients with a healthy (non-cirrhotic, non-steatotic) liver, portal vein embolization is indicated when the standardized FLR is less than 25% of total functional liver volume, as this threshold predicts high risk of post-hepatectomy liver failure. In patients with underlying liver disease (chemotherapy-associated steatohepatitis, cirrhosis), the threshold is higher, typically ≥40%. PVE induces hypertrophy of the FLR over 4–6 weeks before resection.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.