实质充血对ALPPS手术后未来肝剩余部分的快速再生很重要。
Parenchymal Congestion Is Important for Rapid Regeneration of the Future Liver Remnant Following the ALPPS Procedure.
作者信息
Kawaguchi Daisuke, Hiroshima Yukihiko, Matsuo Kenichi, Endo Itaru, Koda Keiji, Tanaka Kuniya
机构信息
Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan.
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
出版信息
Anticancer Res. 2016 Sep;36(9):4731-8. doi: 10.21873/anticanres.11028.
AIM
To evaluate whether the congested area that develops in associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) contributes to rapid future liver remnant (FLR) hypertrophy.
PATIENTS AND METHODS
Eight patients undergoing liver partition and right portal vein (RPV) ligation within the FLR in the first operation of ALPPS were compared with eight patients undergoing RPV embolization in the FLR as the first operation of classical two-stage (CTS) hepatectomy.
RESULTS
Extrapolated kinetic growth of the FLR in ALPPS was 32.7±18.7 ml/day, 7.8-times that in CTS (4.2±2.0 ml/day, p=0.001). Extrapolated kinetic reduction in volume of the ventral aspect of the right paramedian sector, which became congested after the first procedure in ALPPS, was 19.8±11.6 ml/day, 11-times that in CTS (1.8±1.3 ml/day, p=0.001).
CONCLUSION
Production of a congested area within the deportalized liver may contribute importantly to rapid FLR hypertrophy during ALPPS.
目的
评估在联合肝脏分隔与门静脉结扎分期肝切除术（ALPPS）中形成的充血区域是否有助于未来肝剩余（FLR）的快速肥大。
患者与方法
将8例在ALPPS首次手术中于FLR内行肝脏分隔及右门静脉（RPV）结扎的患者，与8例在经典两阶段（CTS）肝切除术首次手术中于FLR内行RPV栓塞的患者进行比较。
结果
ALPPS中FLR的外推动力学生长为32.7±18.7 ml/天，是CTS中（4.2±2.0 ml/天，p = 0.001）的7.8倍。在ALPPS首次手术后变得充血的右旁正中扇形区腹侧体积的外推动力学减少为19.8±11.6 ml/天，是CTS中（1.8±1.3 ml/天，p = 0.001）的11倍。
结论
在去门静脉化肝脏内产生充血区域可能对ALPPS期间FLR的快速肥大起重要作用。
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