Aussilhou B, Lesurtel M, Sauvanet A, Farges O, Dokmak S, Goasguen N, Sibert A, Vilgrain V, Belghiti J
Department of HPB Surgery, Beaujon Hospital (Assistance Publique-Hôpitaux de Paris), Bd Général Leclerc, Clichy, France.
J Gastrointest Surg. 2008 Feb;12(2):297-303. doi: 10.1007/s11605-007-0410-x. Epub 2007 Nov 30.
Aim of this retrospective study was to compare induction of left liver hypertrophy after right portal vein ligation (PVL) and right portal vein embolization (PVE) before right hepatectomy for liver metastases.
Between 1998 and 2005, 18 patients underwent a PVE, whereas 17 patients underwent a PVL during a first stage laparotomy.
There was no complication related to PVE or PVL. After a similar interval time (7 +/- 3 vs 8 +/- 3 weeks), the increase of the left liver volume was similar between the two groups (35 +/- 38 vs 38 +/- 26%). After PVE and PVL, right hepatectomy was performed in 12 and 14 patients, respectively. Technical difficulties during the right hepatectomy were similar according to duration of procedure (6.4 +/- 1 vs 6.7 +/- 1 h, p = 0.7) and transfusion rates (33 vs 28%, p = 0.7). Mortality was nil in both groups, and morbidity rates were respectively 58% for the PVE group and 36% for the PVL group (p = 0.6).
Right PVL and PVE result in a comparable hypertrophy of the left liver. During the first laparotomy of a two-step liver resection, PVL can be efficiently and safely performed.
本回顾性研究的目的是比较在肝转移瘤右肝切除术前，右门静脉结扎（PVL）和右门静脉栓塞（PVE）后左肝肥大的诱导情况。
1998年至2005年间，18例患者接受了PVE，而17例患者在一期剖腹手术中接受了PVL。
未发生与PVE或PVL相关的并发症。在相似的间隔时间后（7±3对8±3周），两组左肝体积的增加相似（35±38对38±26%）。PVE和PVL后，分别有12例和14例患者接受了右肝切除术。根据手术时间（6.4±1对6.7±1小时，p = 0.7）和输血率（33%对28%，p = 0.7），右肝切除术中的技术难度相似。两组均无死亡病例，PVE组和PVL组的发病率分别为58%和36%（p = 0.6）。
右PVL和PVE导致左肝肥大程度相当。在两步肝切除的首次剖腹手术中，PVL可以有效且安全地进行。
