Standardized measurement of the future liver remnant prior to extended liver resection: Methodology and clinical associations
Standardized measurement of the future liver remnant prior to extended liver resection: Methodology and clinical associations
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DOI：
10.1067/msy.2000.105294
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发表时间：
2000-05-01
期刊：
影响因子：
3.8
通讯作者：
Caridi, J
中科院分区：
文献类型：
--
作者：
Vauthey, JN;Chaoui, A;Caridi, J
背景关于扩大肝切除术后残余肝体积的术前测量和最小安全尺寸，目前尚无一致意见。在20例肝胆恶性肿瘤且无潜在慢性肝病的患者中，在扩大右叶切除术（右三叶切除术）之前获得肝脏残留物（第2和3 +/- I段）的体积测量值。使用基于体表面积的公式计算未来肝脏残留与总肝脏体积的比值。在12例患者中，评价了术前右三部门门静脉栓塞的反应。在接受计划切除的IT患者中，术前体积与生化和临床结果参数相关。门静脉栓塞后肝残留增加（26%比36%，P <0.01）。较小的肝脏残留物与术后肝功能检查的增加（P <0.05）和住院时间的延长（P <0.02）相关。初步数据表明，肝脏体积小于或等于25%时，主要并发症增加（P = 0.02）。一种简单的测量方法提供了切除前肝脏残留的评估。它有助于评估门静脉栓塞的反应，并在扩大肝切除术前预测结果。
Background. There is no agreement regarding the preoperative measurement of ever volumes and the minimal safe size of the liver remnant after extended hepatectomy.Methods. In 20 patients with hepatobiliary malignancy and no under lying chronic liver disease, volumetric measurements of the liver remnant (segments 2 and 3 +/- I) were obtained before extended right lobectomy (right trisegmentectomy). The ratios of future liver remnant to total liver volume were calculated by using a formula based on body surface area. In 12 patients, response to preoperative right trisectoral portal vein embolization was evaluated. In IT patients who underwent the planned resection, preoperative volumes were correlated with biochemical and clinical outcome parameters.Results. The future liver remnants increased after portal vein embolization (26% versus 36%, P < .01). Smaller size liver remnants were associated with an increase in postoperative liver function tests (P < .05) and longer lengths of hospital stay (P < .02). Preliminary data indicates an increase in major complications for liver volumes less than or equal to 25% (P = .02).Conclusions. A simple method of measurement provides an assessment of the liver remnant before resection. It is useful in evaluating response to portal vein embolization and in predicating the outcome before extended liver resections.