国际肿瘤学杂志 ›› 2020, Vol. 47 ›› Issue (8): 492-495.doi: 10.3760/cma.j.cn371439-20191112-00063

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ALPPS中肝脏离断技术变异的临床应用进展

刘俊国, 张金卷, 王毅军()   

  1. 天津市第三中心医院肝胆外科 天津市重症疾病体外生命支持重点实验室 天津市人工细胞工程技术研究中心 天津市肝胆研究所 300170
  • 收稿日期:2019-11-12 修回日期:2020-02-20 出版日期:2020-08-08 发布日期:2020-10-22
  • 通讯作者: 王毅军 E-mail:wangyijun_carl@163.com
  • 基金资助:
    天津市卫生行业重点攻关项目(15KG114);天津市科技计划(17YFZCSY01070);天津市科技计划(17ZXMFSY00050)

Clinical application progress of variations in the technique of liver partition from ALPPS

Liu Junguo, Zhang Jinjuan, Wang Yijun()   

  1. Department of Hepatobiliary Surgery, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering, Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
  • Received:2019-11-12 Revised:2020-02-20 Online:2020-08-08 Published:2020-10-22
  • Contact: Wang Yijun E-mail:wangyijun_carl@163.com
  • Supported by:
    Health Industry Key Project of Tianjin(15KG114);Science and Technology Program of Tianjin of China(17YFZCSY01070);Science and Technology Program of Tianjin of China(17ZXMFSY00050)

摘要:

联合肝脏离断和门静脉结扎的二步肝切除术(ALPPS)存在着许多技术上的变异和改良,其主要目的是降低并发症发生率和死亡率,同时可使预留残肝代偿增大更快速和功能更强健。在临床实践中,不同研究者对ALPPS中肝脏离断技术上的变异及其相关的临床结果进行了相应的研究探讨,如部分肝脏离断、门静脉结扎术辅助射频肝分割术、腹腔镜微波消融和门静脉结扎分期肝切除术、联合肝止血带和门静脉结扎分期肝切除术、续贯联合肝止血带和门静脉结扎分期肝切除术、前入路的原位肝实质离段联合门静脉栓塞二期肝切除术、门静脉栓塞代替肝脏实质离断等。

关键词: 肝肿瘤, 肝切除术, 肝脏离断, 门静脉结扎, 预留残肝

Abstract:

There are many technical variations and improvements in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Its main purpose is to reduce the incidence of complications and mortality, and at the same time, the future liver remnant compensation can be increased more faster and its function becomes more robust. In clinical practice, different researchers have studied the variation and related clinical results of liver disconnection technique in ALPPS, such as partial hepatectomy, portal vein ligation assisted radio frequency hepatectomy, laparoscopic microwave ablation and portal vein ligation staged hepatectomy, combined liver tourniquet and portal vein ligation staged hepatectomy, continuous combined liver tourniquet and portal vein ligation staged hepatectomy, in situ hepatectomy combined with portal vein embolization via anterior approach and portal vein embolization instead of hepatectomy separation of visceral substance, and so on.

Key words: Liver neoplasms, Hepatectomy, Associated liver partition, Portal vein ligation, Future liver remnant