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妊娠期肝大部切除术:3例不同病因病例及文献复习

Major liver resection in pregnancy: three cases with different etiologies and review of the literature.

作者信息

Pencovich Niv, Younis Muhammad, Lessing Yonatan, Zac Lilach, Lessing Joseph B, Yogev Yariv, Kupferminc Michael J, Nachmany Ido

机构信息

a Department of Surgery , The Nikolas & Elizabeth Shlezak Fund for Experimental Surgery , Tel Aviv , Israel.

b Division of Anesthesiology, Pain , and Intensive Care , Tel Aviv , Israel.

出版信息

J Matern Fetal Neonatal Med. 2019 Jan;32(2):203-211. doi: 10.1080/14767058.2017.1376315. Epub 2017 Sep 17.

Abstract

BACKGROUND

Major liver resection during pregnancy is extremely rare. When required, the associated physiologic and anatomic changes pose specific challenges and greater risk for both mother and fetus Materials and methods: Three cases of major liver resection during pregnancy due to different etiologies are presented. The relevant literature is reviewed and discussed.

RESULTS

We present three cases of major liver resection due to giant liver hemangioma with Kasabach-Merrit syndrome, giant hydatid cyst, and intrahepatic cholangiocarcinoma, at gestational week (GW) 17, 19, and 30, respectively. All patients had an uneventful postoperative course, continued the pregnancy and gave birth at GW 38.

CONCLUSION

Major liver resection can be performed safely during pregnancy. A multidisciplinary team of surgeons, anesthesiologists and gynecologists, in a highly experienced tertiary hepatobiliary center, should be involved.

摘要

背景

孕期进行大肝切除术极为罕见。如有需要,相关的生理和解剖学变化会给母亲和胎儿带来特殊挑战及更高风险。材料与方法:介绍了三例因不同病因在孕期进行大肝切除术的病例,并对相关文献进行了回顾与讨论。

结果

我们呈现了三例分别因巨大肝血管瘤伴卡萨巴赫-梅里特综合征、巨大包虫囊肿和肝内胆管癌而在孕期第17周、19周和30周进行大肝切除术的病例。所有患者术后过程顺利,继续妊娠并在孕38周分娩。

结论

孕期可安全地进行大肝切除术。应由经验丰富的三级肝胆中心的外科医生、麻醉师和妇科医生组成的多学科团队参与手术。

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