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论著

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): Breaks the barrier between resectable and unresectable.

  • Mohammad Mahboob Hasan Ma Jun-yong Yan Zhen-lin
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  • 1. Combined Military Hospital, Dhaka, Bangladesh, Now working in Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University, Shanghai,
    2. Eastern Hepatobiliary Surgery Hospital of the Second Militari Medical University, Shanghai,

收稿日期: 2015-12-23

  修回日期: 2016-06-29

  网络出版日期: 2016-10-27

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): Breaks the barrier between resectable and unresectable.

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Received date: 2015-12-23

  Revised date: 2016-06-29

  Online published: 2016-10-27

摘要

肝功能衰竭仍是导致患者肝切除术后死亡的主要因素。残余肝脏体积(future liver remnant, FLR)不足是肝切除术的一个主要阻碍。肝切除术的安全标志是术后肝功能临界状态和足够的残余肝脏体积。联合肝脏离断和门静脉结扎的二步肝切除术(associated liver partition and portal vein ligation for staged hepatectomy, ALPPS)是一种创新性的手术方式,可用于残余肝脏体积不足本不能耐受扩大肝切除术的患者,待FLR增生足以耐受扩大肝切除术的水平。 本文综述ALPPS的建立及其与传统方法在提高残余肝脏体积方面的对比。 本文对ALPPS及其它方法促使肝脏增生的病理生理学机制进行了详细讨论,并通过相关文献对其结果和预后进行综述。

本文引用格式

Mohammad Mahboob Hasan Ma Jun-yong Yan Zhen-lin . Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): Breaks the barrier between resectable and unresectable.[J]. 外科研究与新技术(中英文), 2016 , 5(3) : 201 -207,215 . DOI: 10.3969/j.issn.2095-378X.2016.03.017

Abstract

Liver failure is still the main issue for the post hepatectomy mortality. The main obstacle for hepatectomy is insufficient future liver remnant (FLR). Safety markers of hepatic resection are borderline liver function and sufficient volume of FLR. Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a new innovation to increase FLR to the desired volume permitting extended hepatectomy for patients with initially insufficient FLR. This article reviews the emergent and surgical aspect of ALPPS in comparison to traditional methods to increase FLR. Pathophysiology of liver hypertrophy following ALPPS and other methods are discussed in details. Outcome and prognosis are also reviewed through relevant literatures.

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