Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy
Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy
复制标题
DOI：
10.1007/s11605-018-3985-5
复制
发表时间：
2019-05-01
影响因子：
3.2
通讯作者：
Uchiyama, Kazuhisa
中科院分区：
文献类型：
--
作者：
Inoue, Yoshihiro;Fujii, Kensuke;Uchiyama, Kazuhisa
背景肝切除术后肝再生是肝外科医生非常感兴趣的，了解再生的过程可以有助于增加肝切除术的安全性和改善prostheses.Methods538例接受肝切除术的患者进行了回顾性分析。评价术后结局，重点关注门静脉切除和切除肝脏体积对肝脏肿瘤患者残肝再生的影响。残肝体积（RLVs）和实验室数据进行了测量，术后第7天和1个月，2，5，12，24后option.ResultsLiver再生速度在术后1周达到高峰，并逐渐下降。大切除的再生时间长于小切除，在所有时间点，前者的残肝再生率均显著低于后者。残肝再生在术后5个月左右达到稳定，此时再生几乎完全。术后1个月，当切除更多的门静脉时，实验室数据明显变差。结论残肝再生的速度和速率主要与切除的门静脉数目和肝实质切除量有关。切除率越大，肝脏再生所需的时间就越长。我们证实了肝脏功能方面的恢复伴随着RLV的恢复。
BackgroundPost-hepatectomy liver regeneration is of great interest to liver surgeons, and understanding the process of regeneration could contribute to increasing the safety of hepatectomies and improving prognoses.MethodsFive hundred thirty-eight patients who underwent hepatectomy were retrospectively analyzed. Postoperative outcomes were evaluated, with a focus on the effects of portal vein resection and resected liver volume on remnant liver regeneration in patients with liver tumors. Remnant liver volumes (RLVs) and laboratory data were measured postoperatively using multidetector computed tomography on day 7 and months 1, 2, 5, 12, and 24 after the operation.ResultsLiver regeneration speed peaked at 1week postoperatively and gradually decreased. Regeneration with large resections was longer than that with small resections, with the remnant liver regeneration rate being significantly lower in the former at all time points. Remnant liver regeneration plateaued around 5months postoperatively, when regeneration is almost complete. Up to 1month postoperatively, laboratory data were significantly worse when more portal veins was resected. After 2months postoperatively, these data recovered to near normal levels.ConclusionThe speed and rate of remnant liver regeneration primarily showed a strong correlation with the number of resected portal veins and the amount of removed liver parenchyma. The larger the resection ratio, the longer it took the liver to regenerate. We confirmed that recovery of the liver's functional aspects accompanies recovery of the RLV.