Approach

Method

Advantages

Disadvantages

Ipsilateral

Cannulation of diseased liver to puncture the portal vein

Decreased risk of injury to the future liver remnant

Risk of seeding the tumour

Migration of embolic material to the contralateral segment

Contralateral

Cannulation of the portal vein from the normal liver (FLR)

Anatomical easy route to gain access to portal vein

Injury to the FLR

Embolic material migration to the left lobe of the liver

Laparotomy and Ileo-colic- SMV

Puncture of ileo-colonic vein to gain assess to portal vein

Visualisation of peritoneal cavity

Assessment of gross liver architecture and FLR

Risk from laparotomy

Injury to bowel

Portal vein thrombosis