Shan Yan-Shen, Hsieh Yu-Hsiang, Sy Edgar D, Chiu Nan-Tsing, Lin Pin-Wen
Department of Surgery, National Cheng Kung University Hopsital, National Cheng Kung University, Tainan 70428, Taiwan.
Liver Int. 2005 Feb;25(1):96-100. doi: 10.1111/j.1478-3231.2005.01037.x.
BACKGROUND/PURPOSE: The relationship between liver regeneration and spleen size after major hepatectomy in normal and cirrhotic liver was studied by single photon emission computed tomography (SPECT).
Twenty-six patients, 18 patients with normal liver and eight patients with cirrhotic liver, receiving major hepatectomy were included. Liver and spleen volumes were measured by SPECT before major hepatectomy, 6 months, 1 year and 2 years after operation. The correlation of liver and spleen volume during liver regeneration was analyzed.
In both groups, the residual liver volume increased within the first year and decreased in the second year. No difference in regeneration ability was found. The spleen volume in cirrhotic liver was increased, with a trend similar to normal liver during the first year. In contrast, the increased spleen volume persisted up to the second year in cirrhotic patients. Age per year, the female sex, and body surface index had a positive correlation with increased percentage of liver volume. The spleen volume per 100 ml with time played a significantly negative role in increasing percentage of liver volume, confidence interval: -2.16 to -27.92, P=0.011.
In early cirrhotic liver within normal functional limits, the liver still could regenerate as a normal liver after major hepatectomy in 1 year. Age, the female sex, and body surface index had positive correlation but the size of spleen volume played a negative role to regenerative liver volume.
背景/目的:通过单光子发射计算机断层扫描(SPECT)研究正常肝脏和肝硬化肝脏在接受大肝切除术后肝脏再生与脾脏大小之间的关系。
纳入26例接受大肝切除术的患者,其中18例为正常肝脏患者,8例为肝硬化肝脏患者。在大肝切除术前、术后6个月、1年和2年通过SPECT测量肝脏和脾脏体积。分析肝脏再生过程中肝脏和脾脏体积的相关性。
两组患者的残余肝脏体积在第一年增加,在第二年减少。未发现再生能力存在差异。肝硬化肝脏患者的脾脏体积增大,在第一年其变化趋势与正常肝脏相似。相比之下,肝硬化患者的脾脏体积增大一直持续到第二年。年龄每年增长、女性性别以及体表面积指数与肝脏体积增加百分比呈正相关。每100 ml脾脏体积随时间变化对肝脏体积增加百分比具有显著的负向作用,置信区间:-2.16至-27.92,P = 0.011。
在功能正常范围内的早期肝硬化肝脏,大肝切除术后1年内肝脏仍可像正常肝脏一样再生。年龄、女性性别和体表面积指数呈正相关,但脾脏体积大小对再生肝脏体积起负向作用。