经结肠间肝门静脉栓塞术增加了大肝切除术后剩余肝脏的体积。
Transileocolic Portal Vein Embolization Increases Remnant Liver Volume After Major Hepatectomy.
机构信息
Department of Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan;
Department of Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan.
出版信息
In Vivo. 2024 Nov-Dec;38(6):2761-2766. doi: 10.21873/invivo.13755.
BACKGROUND/AIM: Transileocolic portal vein embolization (TIPE) may reduce the risk of liver failure after massive hepatectomy. However, convincing evidence of its usefulness in this regard is yet to be reported. Therefore, this study aimed to investigate the use of TIPE after massive hepatectomy.
PATIENTS AND METHODS
Twelve patients who underwent TIPE were included. Pre- and postoperative liver volumetry was determined using a 3D simulator with computed tomography.
RESULTS
After TIPE, the percent change in total liver volume was 104.0%±13.1% (p=0.08). Conversely, the percent increase in remnant liver volume (ml)/total liver volume (ml) and remnant liver volume (ml)/standard liver volume (ml) was 122.9%±18.6% (p<0.001) and 132.2%±19.6% (p<0.001), respectively. TIPE operation time was 125±84.6 min, with minimal blood loss in all cases. Postoperative hospitalization duration during TIPE was 4.5±2.6 days. No TIPE-related complications occurred in any patient.
CONCLUSION
TIPE is beneficial and safe when preoperative volumetry indicates that the remaining liver volume is inadequate and inoperable.
背景/目的：经结肠间门静脉栓塞术（TIPE）可能降低大范围肝切除术后肝衰竭的风险。然而，其在这方面有效性的令人信服的证据尚未报道。因此，本研究旨在调查 TIPE 在大范围肝切除术后的应用。
患者与方法
纳入 12 例行 TIPE 的患者。使用 CT 三维模拟器进行术前和术后肝脏体积测量。
结果
TIPE 后，总肝体积的变化百分比为 104.0%±13.1%（p=0.08）。相反，剩余肝体积（ml）/总肝体积（ml）和剩余肝体积（ml）/标准肝体积（ml）的增加百分比分别为 122.9%±18.6%（p<0.001）和 132.2%±19.6%（p<0.001）。TIPE 手术时间为 125±84.6 分钟，所有病例均有少量失血。TIPE 术后住院时间为 4.5±2.6 天。所有患者均未发生 TIPE 相关并发症。
结论
当术前体积测量表明剩余肝体积不足且无法手术时，TIPE 是有益且安全的。
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