Department of Radiology, IRCCS San Raffaele Hospital, Milan, Italy; Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Universita Vita-Salute San Raffaele, Milan, Italy.
Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy; PhD School in Experimental Medicine, University of Pavia, Pavia, Italy.
J Vasc Interv Radiol. 2022 May;33(5):525-529. doi: 10.1016/j.jvir.2022.01.018.
Future liver remnant (FLR) volume is an important indicator of the risk of posthepatectomy liver failure (PHLF) and limits the feasibility of major hepatectomies. A case series of 5 patients treated with a novel approach is presented. Laparoscopic liver partitioning was combined with subsequent liver venous deprivation (embolization of both the portal and the hepatic veins). Baseline average FLR was 28.8%. All procedures were successfully performed without major complications. Mean 1-, 2- and 4-week hypertrophy of the FLR were 35%, 40.3%, and 46.4%, respectively. Four patients underwent planned surgery after a mean interval of 28 days. Of these, 2 patients achieved sufficient FLR volume and function after 2 weeks and underwent surgery before the 4-week volumetric analysis. One patient did not undergo surgery because of intraoperative diagnosis of peritoneal metastases. No cases of PHLF were observed at 5-day follow-up.
未来肝脏残余量（FLR）是肝切除术后肝功能衰竭（PHLF）风险的重要指标，限制了大肝切除术的可行性。本文介绍了 5 例采用新方法治疗的病例系列。腹腔镜下肝分割术结合后续肝静脉剥夺（门静脉和肝静脉栓塞）。基线平均 FLR 为 28.8%。所有手术均成功完成，无重大并发症。FLR 的平均 1、2 和 4 周的增生率分别为 35%、40.3%和 46.4%。4 例患者在平均 28 天后进行了计划手术。其中 2 例在 2 周后获得了足够的 FLR 体积和功能，并在 4 周体积分析前进行了手术。1 例患者因术中诊断为腹膜转移而未行手术。在 5 天的随访中，没有观察到 PHLF 病例。
