用“字母组合疗法”为肝脏手术做准备：门静脉栓塞术（PVE）、联合肝脏分隔和门静脉结扎的二步肝切除术（ALPPS）、经动脉化疗栓塞联合门静脉栓塞术（TAE-PVE）、肝静脉结扎术（LVD）和右半肝切除术（RL）。
Preparing for liver surgery with "Alphabet Soup": PVE, ALPPS, TAE-PVE, LVD and RL.
作者信息
Kim DaeHee, Cornman-Homonoff Joshua, Madoff David C
机构信息
Department of Radiology, Division of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Radiology and Biomedical Imaging, Section of Interventional Radiology, Yale School of Medicine, New Haven, CT, USA.
出版信息
Hepatobiliary Surg Nutr. 2020 Apr;9(2):136-151. doi: 10.21037/hbsn.2019.09.10.
Abstract
Future liver remnant (FLR) size and function is a critical limiting factor for treatment eligibility and postoperative prognosis when considering surgical hepatectomy. Pre-operative portal vein embolization (PVE) has been proven effective in modulating FLR and now widely accepted as a standard of care. However, PVE is not always effective due to potentially inadequate augmentation of the FLR as well as tumor progression while awaiting liver growth. These concerns have prompted exploration of alternative techniques: associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), transarterial embolization-portal vein embolization (TAE-PVE), liver venous deprivation (LVD), and radiation lobectomy (RL). The article aims to review the principles and applications of PVE and these newer hepatic regenerative techniques.
摘要
在考虑进行肝切除术时，未来肝残余量（FLR）的大小和功能是决定治疗可行性及术后预后的关键限制因素。术前门静脉栓塞术（PVE）已被证明在调节FLR方面有效，目前已被广泛接受为一种标准治疗方法。然而，由于在等待肝脏生长期间FLR可能增大不足以及肿瘤进展，PVE并不总是有效。这些问题促使人们探索其他技术：联合肝脏分隔和门静脉结扎分期肝切除术（ALPPS）、经动脉栓塞-门静脉栓塞术（TAE-PVE）、肝静脉阻断术（LVD）和放射叶切除术（RL）。本文旨在综述PVE以及这些更新的肝脏再生技术的原理和应用。
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Preparing for liver surgery with "Alphabet Soup": PVE, ALPPS, TAE-PVE, LVD and RL.用“字母组合疗法”为肝脏手术做准备：门静脉栓塞术（PVE）、联合肝脏分隔和门静脉结扎的二步肝切除术（ALPPS）、经动脉化疗栓塞联合门静脉栓塞术（TAE-PVE）、肝静脉结扎术（LVD）和右半肝切除术（RL）。
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