Parenchymal Congestion Is Important for Rapid Regeneration of the Future Liver Remnant Following the ALPPS Procedure.
Parenchymal Congestion Is Important for Rapid Regeneration of the Future Liver Remnant Following the ALPPS Procedure.
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DOI：
10.21873/anticanres.11028
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发表时间：
2016-09
影响因子：
2
通讯作者：
Daisuke Kawaguchi;Yukihiko Hiroshima;K. Matsuo;I. Endo;K. Koda;Kuniya Tanaka
中科院分区：
文献类型：
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作者：
Daisuke Kawaguchi;Yukihiko Hiroshima;K. Matsuo;I. Endo;K. Koda;Kuniya Tanaka
目的探讨分肝术联合门静脉结扎术(ALPPS)所形成的充血区域是否会导致残肝(FLR)的快速肥大。患者和方法对8例ALPPS首次手术中在FLR行肝分割右门静脉(RPV)结扎的患者和8例在FLR行RPV栓塞术的经典二期(CTS)肝切除术患者进行比较。结果外推急性肺泡灌洗液中FLR32.7±18.7ml/d，是CTS的7.8倍(4.2±2.0ml/d，p=0.001)。外推右旁正中节段腹侧充血的动态缩小量为19.8±11.6ml/d，是对照组的11倍(1.8±1.3ml/d，p=0.001)。结论在ALPPS期间，肝内充血区域的形成可能是导致FLR快速肥大的重要原因。
AIM To evaluate whether the congested area that develops in associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) contributes to rapid future liver remnant (FLR) hypertrophy. PATIENTS AND METHODS Eight patients undergoing liver partition and right portal vein (RPV) ligation within the FLR in the first operation of ALPPS were compared with eight patients undergoing RPV embolization in the FLR as the first operation of classical two-stage (CTS) hepatectomy. RESULTS Extrapolated kinetic growth of the FLR in ALPPS was 32.7±18.7 ml/day, 7.8-times that in CTS (4.2±2.0 ml/day, p=0.001). Extrapolated kinetic reduction in volume of the ventral aspect of the right paramedian sector, which became congested after the first procedure in ALPPS, was 19.8±11.6 ml/day, 11-times that in CTS (1.8±1.3 ml/day, p=0.001). CONCLUSION Production of a congested area within the deportalized liver may contribute importantly to rapid FLR hypertrophy during ALPPS.