Abuduhaibaier Sadula, Ren S Q, Yuan C H, Xiu D R
Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Wai Ke Za Zhi. 2020 Nov 1;58(11):835-840. doi: 10.3760/cma.j.cn112139-20200218-00094.
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can speed up the regeneration of future liver remnant (FLR) in short period of time, and offer a chance for surgical resection for patients without sufficient FLR. However, ALPPS still remains controversy due to its high perioperative morbidity and mortality, as well as the uncertain long-term oncological benefits. How to solve these problems is the key to ensure the safety of surgery.This article focus on the indication selection, liver function reserve evaluation and timing to perform the second stage surgery, surgical mode evolution and comparison with portal venous embolization/portal venous ligation+two-stage hepatectomy.
联合肝脏分隔和门静脉结扎的分期肝切除术（ALPPS）可在短时间内加速未来肝残余（FLR）的再生，并为FLR不足的患者提供手术切除机会。然而，由于其围手术期高发病率和死亡率以及长期肿瘤学获益的不确定性，ALPPS仍存在争议。如何解决这些问题是确保手术安全的关键。本文重点关注适应证选择、肝功能储备评估及二期手术时机、手术方式演变以及与门静脉栓塞/门静脉结扎+二期肝切除术的比较。
