Zerial Michele, Lorenzin Dario, Risaliti Andrea, Zuiani Chiara, Girometti Rossano
Michele Zerial, Chiara Zuiani, Rossano Girometti, Institute of Diagnostic Radiology, Department of Medicine, University of Udine, University Hospital "S. Maria della Misericordia", 33100 Udine, Italy.
World J Hepatol. 2017 Jun 8;9(16):733-745. doi: 10.4254/wjh.v9.i16.733.
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a recently introduced technique aimed to perform two-stage hepatectomy in patients with a variety of primary or secondary neoplastic lesions. ALPSS is based on a preliminary liver resection associated with ligation of the portal branch directed to the diseased hemiliver (DH), followed by hepatectomy after an interval of time in which the future liver remnant (FLR) hypertrophied adequately (partly because of preserved arterialization of the DH). Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) play a pivotal role in patients' selection and FLR assessment before and after the procedure, as well as in monitoring early and late complications, as we aim to review in this paper. Moreover, we illustrate main abdominal MDCT and MRI findings related to ALPPS.
联合肝脏分隔和门静脉结扎的分期肝切除术(ALPPS)是一种最近引入的技术,旨在为患有各种原发性或继发性肿瘤病变的患者实施两期肝切除术。ALPSS基于与结扎通向患病半肝(DH)的门静脉分支相关的初步肝切除术,随后在一段时间间隔后进行肝切除术,在此期间未来肝脏残余(FLR)充分肥大(部分原因是DH的动脉血供得以保留)。多层螺旋计算机断层扫描(MDCT)和磁共振成像(MRI)在患者术前和术后的选择及FLR评估中发挥关键作用,同时在监测早期和晚期并发症方面也很重要,正如我们在本文中旨在阐述的。此外,我们还说明了与ALPPS相关的主要腹部MDCT和MRI表现。