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经颈静脉途径是进行门静脉栓塞的一种安全有效的替代方法。

The transjugular approach is a safe and effective alternative for performing portal vein embolization.

作者信息

Jiang Ming-Shan, Luo Xue-Feng, Wang Zhu, Li Xiao

机构信息

Department of Gastroenterology.

Institution of Interventional Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Medicine (Baltimore). 2019 Nov;98(45):e17851. doi: 10.1097/MD.0000000000017851.

Abstract

To evaluate the safety and efficacy of the novel technique, transjugular portal vein embolization (TPVE).A single-center retrospective review of 18 patients (12 males and 6 females; mean age, 62 years) who underwent TPVE between January 2012 and January 2013 was conducted. The technical success rate, future liver remnant (FLR) volume, total liver volume (TLV) and FLR/TLV ratio after PVE were analyzed. Liver function, including total bilirubin (TB), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and International Normalized Ratio (INR), was assessed before and after PVE. Any complications of TPVE and liver resection after TPVE were recorded.TPVE was performed on 18 patients before right hepatic resection for both primary and secondary hepatic malignancies (10 hepatocellular carcinomas, 4 cases of colorectal liver metastasis, and 4 cholangiocarcinomas). Technical success was achieved in 100% of patients (18 of 18). The mean FRL significantly increased to 580 ± 155 mL (P < .001) after PVE. The mean FLR/TLV ratio (%) significantly increased to 34 ± 4 (P < .001) after PVE. One patient suffered septicemia after TPVE. A small number patients experienced mild to moderate abdominal pain during TPVE. No other major complications occurred after TPVE in our study. The patient who developed septicemia died 3 days after the surgery as a result of this complication and subsequent multiple organ dysfunction syndrome (MODS).Transjugular portal vein embolization is a safe, efficacious, and promising novel technique to induce hypertrophy of the FLR.

摘要

为评估经颈静脉门静脉栓塞术(TPVE)这项新技术的安全性和有效性,我们对2012年1月至2013年1月期间接受TPVE的18例患者(12例男性和6例女性;平均年龄62岁)进行了单中心回顾性研究。分析了PVE后的技术成功率、未来肝残余(FLR)体积、全肝体积(TLV)以及FLR/TLV比值。评估了PVE前后的肝功能,包括总胆红素(TB)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和国际标准化比值(INR)。记录了TPVE的任何并发症以及TPVE后的肝切除情况。

18例原发性和继发性肝恶性肿瘤患者(10例肝细胞癌、4例结直肠癌肝转移和4例胆管癌)在右肝切除术前接受了TPVE。100%的患者(18/18)获得技术成功。PVE后平均FRL显著增加至580±155 mL(P<0.001)。PVE后平均FLR/TLV比值(%)显著增加至34±4(P<0.001)。1例患者在TPVE后发生败血症。少数患者在TPVE期间经历轻度至中度腹痛。在我们的研究中,TPVE后未发生其他重大并发症。发生败血症的患者术后3天因该并发症及随后的多器官功能障碍综合征(MODS)死亡。

经颈静脉门静脉栓塞术是一种安全、有效且有前景的诱导FLR肥大的新技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c992/6855494/70bf2c4cfc45/medi-98-e17851-g001.jpg

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