摘要
剩余肝体积(RLV)不足是肝切除术后肝功能衰竭和患者死亡的主要原因。肝泡型包虫(HAE)常侵及肝内外重要血管,致使功能肝段的保留极为困难,根治性切除率低。尽管离体肝切除联合自体肝移植术(ERAT)极大拓宽了晚期HAE手术指征,但RLV不足仍是限制HAE根治性切除的主要因素。近年来,包括分期肝切除、肝静脉支架置入序贯ERAT、辅助性ERAT、联合肝脏离断和门静脉结扎的二步肝切除术(ALPPS)等多种手段已应用于RLV不足晚期HAE的外科治疗,提高了晚期HAE的根治性切除率。笔者对RLV不足的晚期HAE患者外科治疗新进展做一综述。
The insufficient remnant liver volume(RLV)is the main reason for postoperative hepatic failure and death of patients.The lesions of hepatic alveolar echinococcosis(HAE)often involve the intra-and extra-hepatic vessels,which causes difficult situations for preservation of the functional hepatic segment(s)and low radical resection rates.Although the ex-vivo liver resection combined with autologous liver transplantation(ERAT)has greatly extended the surgical indications for end-stage HAE,the insufficient RLV remains the restrictions on HAE radical resection.In recent years,some novel techniques such as the staged hepatectomy,percutaneous stenting of hepatic vein followed by ERAT,and auxiliary ERAT as well as the associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)have been applied in the surgical treatment for HAE patients with insufficient RLV,which improve the radical resection rate for end-stage HAE.Herein,the authors present a brief overview on the latest surgical progress for end-stage HAE with insufficient RLV.
作者
杨冲
杨洪吉
邓绍平
张宇
YANG Chong;YANG Hongji;DENG Shaoping;ZHANG Yu(Organ Transplantation Center,Sichuan Provincial People’s Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610072,China)
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2021年第1期98-104,共7页
China Journal of General Surgery
基金
国家卫生健康委包虫病防治研究重点实验室开放课题基金资助项目(2020WZK2010)
中国科学院西部之光青年学者基金资助项目(2019年度)。
关键词
棘球蚴病
肝
剩余肝体积
肝切除术
肝移植
支架
Echinococcosis,Hepatic
Remnant Liver Volume
Hepatectomy
Liver Transplantation
Stents
