Trans-ileocecal portal vein embolization as a preoperative treatment for right trisegmentectomy with caudate lobectomy
Trans-ileocecal portal vein embolization as a preoperative treatment for right trisegmentectomy with caudate lobectomy
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DOI：
10.1002/jso.20829
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发表时间：
2007-10-01
影响因子：
2.5
通讯作者：
Kuwano, Hiroyuki
中科院分区：
文献类型：
--
作者：
Shimura, Tatsuo;Suehiro, Taketoshi;Kuwano, Hiroyuki
背景和目标：术前门静脉栓塞（PVE）的适应症已扩展至肝细胞癌、胆管细胞癌（CCC）、肝转移、胆囊癌（GB）以及肝门部胆管癌（hCC）。然而，胆管癌有时会导致腹膜dispersion.Patients和方法：我们进行了我们的术前trans-ileocal-vein PVE（TIPE）的方法对14（3 GB癌，1 CCC，和10 hCC），其估计的剩余肝体积<30%.Results：在14例患者中，腹膜播散遇到了两个GB癌和一个hCC（21.4%）在我们的程序。PVE后14天，无胆管炎诱因的患者的估计残余肝脏体积为37.4 +/-2.7%，而胆管炎患者为29.3 +/-1.3%（P = 0.0002）。结论：PTPE是HCC、肝癌和肝转移瘤患者的首选治疗方法。虽然这里提出的TIPE有一些潜在的缺点，但我们特别推荐它用于GB癌患者，因为它很有可能引起癌性腹膜炎。当患者有诱发性胆管炎时，根治性手术应安排在PVE后> 21天，而不是14天。
Background and Objectives: The indication of preoperative portal vein embolization (PVE) has been expanded to hepatocellular carcinoma, cholangiocellular carcinoma (CCC), hepatic metastasis, and gallbladder (GB) cancer as well as hilar cholangiocarcinoma (hCC). However, biliary cancers sometimes cause peritoneal dissemination.Patients and Methods: We performed our preoperative trans-ileocecal-vein PVE (TIPE) method on 14 (3 GB cancer, I CCC, and 10 hCC), whose estimated residual liver volume was < 30%.Results: Out of 14 patients, peritoneal dissemination was encountered in two patients with GB cancer and one with hCC (21.4%) during our procedure. The estimated residual liver volume was 37.4 +/- 2.7% at 14 days after PVE in patients without predisposing cholangitis, while those in patients with cholangitis was 29.3 +/- 1.3% (P = 0.0002). No major complication due to the procedure was encountered in this series.Conclusions: PTPE could be the first choice for patients with hCC, hepatocellular carcinoma, and hepatic metastases. Although the TIPE proposed here has some potential disadvantages, we would recommend it especially for patients with GB cancer because of its high potential to cause cancerous peritonitis. When a patient had predisposing cholangitis, radical operation should be scheduled on > 21 days after PVE rather than on 14 days.