中国实用外科杂志Issue(8)：739-743,5.DOI:10.7504/CJPS.ISSN1005-2208.2014.08.19
联合肝脏离断和门静脉结扎二步肝切除术治疗肝硬化肝癌疗效分析（附1例报告）
Associating liver partition and portal vein ligation for staged hepatectomy for HCC with liver cirrhosis:A report of 1 case
洪德飞 1吴兆平 2王知非 1黄东胜 1欧阳霆 2刘合春 2彭淑牖 1陈伟力 1胡秋灵 2张远标 1邹勇 2成剑 1淦勤2
作者信息
- 1. 浙江省人民医院肝胆胰外科，浙江杭州310014
- 2. 九江人民医院肝胆胰外科，江西九江332000
- 折叠
摘要
Abstract
Objective To discuss the safety and effectiveness of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma complicated with liver cirrhosis. Methods ALPPS was performed for 1 cases of huge HCC on right liver complicated with liver cirrhosis on March 7, 2014 in Department of Hepatobiliarypancreatic Surgery, Zhejiang Provincial People’s Hospital. Data of perioperative period were recorded and analyzed. The surgical plan includes:first,SⅡ,SⅢand SⅣsegment were dissected with an anterior in situ approach and right portal vein was ligated. After 15 days, a combination of antegrade and retrograde approach were applied in right liver lobectomy. Results The remnant liver volume was 460.8 mL before the first step of operation,which was increased by 65.0% to 760.2 mL before the second step of operation. The standard whole liver volume was 1019.3 mL. The standard remnant liver volume was 320 mL/m2 before the first step of operation,and was 527.9 mL/m2 before the second step of operation,which accounted for 31.4%and 52.0%of the standard whole liver volume respectively. The operative time for the first step and second step of operation was 188 min and 124 min. The intraoperative bleeding was 2000 mL and 400 mL respectivey. The time for restore to normal liver function postoperatively was 6 d and 4 d. Complication of minimal bile leakage,ascites and partial arterial thrombosis in lower lobe of right lung occurred after the first step of operation. No complication occurred after the second step of operation. The patients were discharged 10 d postoperatively. Conclusion The modified ALPPS provides a new strategy for the cases of HCC with cirrhosis who couldn’t tolerate the radical resection due to the insufficient remnant liver volume.关键词
肝硬化/原发性肝癌/剩余肝脏体积/二步肝切除术/门静脉结扎Key words
liver cirrhosis/primary hepatic carcinoma/remnant liver volume/staged hepatectomy/portal vein ligation分类
医药卫生引用本文复制引用
洪德飞,吴兆平,王知非,黄东胜,欧阳霆,刘合春,彭淑牖,陈伟力,胡秋灵,张远标,邹勇,成剑,淦勤..联合肝脏离断和门静脉结扎二步肝切除术治疗肝硬化肝癌疗效分析（附1例报告）[J].中国实用外科杂志,2014,(8):739-743,5.
