中国普通外科杂志2016，Vol.25Issue(7)：965-972,8.DOI:10.3978/j.issn.1005-6947.2016.07.006
联合肝脏离断和门静脉结扎的二步肝切除术治疗肝硬化巨大肝癌2例报告并文献复习
Associating liver partition and portal vein ligation for staged hepatectomy in treatment of massive liver cancer with cirrhosis：a report of 2 cases and literature review
杨扬 1程张军 1周家华 1余泽前 1王立山 1靳激扬 2朱光宇3
作者信息
- 1. 东南大学附属中大医院肝胆胰中心，江苏 南京 210009
- 2. 东南大学附属中大医院放射科，江苏 南京 210009
- 3. 东南大学附属中大医院介入与血管外科，江苏 南京 210009
- 折叠
摘要
Abstract
Objective: To investigate the feasibility and safety of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in treatment of massive hepatocellular carcinoma with cirrhosis. <br> Methods: The clinical data of two patients with massive right lobe primary hepatocellular carcinoma and concomitant cirrhosis undergoing ALPPS in Affiliated Zhongda Hospital of Southeast University in August 2014 and January 2015 respectively were retrospectively analyzed. hTe treatment effcacy was assessed by using perioperative variables and follow-up data. <br> Results: Both patients underwent first-stage surgical procedures of right portal vein ligation and in situ partitioning of the liver parenchyma. hTe remnant liver volume was rapidly increased in both of them atfer the ifrst-stage operation, which in case 1 increased to 704.8 mL (accounted for 60.3% of the standard liver volume) at postoperative day (POD) 6, and in case 2 increased to 771.3 mL (accounted for 63.6% of the standard liver volume) at POD 11. Both patients then underwent second-stage extended right hemihepatectomy. hTe operative time for the ifrst-stage procedure was 240 min and 210 min respectively, with intraoperative blood loss of 600 mL in each case; the operative time for the second-stage procedures was 300 min and 325 min, with intraoperative blood losses of 1 000 mL and 800 mL, respectively. No perioperative death or serious postoperative complications occurred in either patient, and both patients were alive and no new intra- or extra-hepatic recurrence was observed in either of them during 6-month follow-up period. <br> Conclusion: ALPPS is safe and feasible for massive liver cancer with cirrhosis.关键词
肝肿瘤/外科学/肝切除术/方法/肝硬化/未来剩余肝脏体积Key words
Liver Neoplasms/surg/Hepatectomy/methods/Liver Cirrhosis/Future Liver Remnant分类
医药卫生引用本文复制引用
杨扬,程张军,周家华,余泽前,王立山,靳激扬,朱光宇..联合肝脏离断和门静脉结扎的二步肝切除术治疗肝硬化巨大肝癌2例报告并文献复习[J].中国普通外科杂志,2016,25(7):965-972,8.
