Analysis of unique liver volume restoration after laparoscopic fenestration of liver cysts.
Analysis of unique liver volume restoration after laparoscopic fenestration of liver cysts.
复制标题
腹腔镜肝囊肿开窗术后独特的肝脏体积恢复分析。
DOI：
10.1111/ases.12092
复制
发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Fujimoto J.
中科院分区：
文献类型：
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作者：
Iimuro Y;Okada T;Kondo Y;Suzumura K;Uyama N;Uda Y;Yamanaka J;Fujimoto J.
腹腔镜开窗术是治疗非寄生虫性肝囊肿的标准手术。开窗术后，残肝通常恢复其体积。然而，没有对这一现象进行系统的分析。本研究分析了腹腔镜肝囊肿开窗术后肝脏体积恢复的模式，并探讨了独特恢复的机制。方法7例巨大非寄生虫性肝囊肿患者接受了腹腔镜开窗术。通过CT或MRI分析开窗术后各断面肝脏体积恢复情况和门静脉分支直径的变化。在两名患者中，使用区域生长软件详细评估了局部肝脏体积恢复，并使用计算流体动力学估计了门静脉血流分布的变化。然后，区域肝体积恢复率与门静脉血流动力学changes.ResultsLiver体积恢复后开窗术是依赖于囊肿的大小和位置，它不均匀的整个残肝。开窗术后，被巨大囊肿压迫的部分的肝脏体积恢复明显大于其他区域。这种体积恢复伴随着这些切片中门静脉分支直径的增加。此外，区域肝体积恢复率和门静脉血流分布的变化之间存在很强的相关性，在计算分析cases.ConclusionLiver体积恢复后，巨大肝囊肿开窗术不均匀发生在残肝。邻近切除的巨大肝囊肿的肝区门静脉循环的改善最可能调节该区域更大的区域体积恢复率。
IntroductionLaparoscopic fenestration is a standard procedure for the treatment of non‐parasitic liver cysts. After fenestration, the remnant liver often restores its volume. However, no systematic analysis of the phenomenon exists. In the present study, the pattern of liver volume restoration after laparoscopic fenestration of liver cysts was analyzed, and the mechanism for the unique restoration was investigated.MethodsSeven patients with giant non‐parasitic liver cysts underwent laparoscopic fenestration. Liver volume restoration in each section and changes in the diameter of the portal branch were analyzed after fenestration with CT or MRI. In two patients, regional liver volume restoration was assessed in detail using region‐growing software, and change in portal flow distribution was estimated using computational fluid dynamics. Then, the regional liver volume restoration rate was compared with the portal hemodynamic changes.ResultsLiver volume restoration after fenestration was dependent on the size and position of the cysts; it not uniform throughout the remnant liver. The liver volume restoration in sections that had been compressed by giant cysts was significantly greater than in other areas after fenestration. This volume restoration was accompanied by an increase in the diameters of the portal branches in these sections. In addition, a strong correlation between the regional liver volume restoration rate and the changes in portal flow distribution existed in the computationally analyzed cases.ConclusionLiver volume restoration after the fenestration of giant liver cysts non‐uniformly occurs in the remnant liver. Improved portal vein circulation in the hepatic area adjacent to the excised giant liver cysts most likely regulates the greater regional volume restoration rate in the area.