Selection of Candidates for Extensive Liver Resection with Measurement of Functional Reserve of the Remnant Liver.

通过测量残余肝脏的功能储备来选择广泛肝切除术的候选者。

• 批准号: 01570766
• 负责人: TSUZUKI Toshiharu
• 金额: $ 1.34万
• 依托单位: School of Medicine, Keio University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1989
• 资助国家: 日本
• 起止时间: 1989 至 1990
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-01570766/
• 关键词: liver cirrhosis; liver resection; liver failure; functional reserve; 肝硬変併存肝癌; 残存肝予定領域

To select patients with sufficient functional reserve of the liver, we have preoperatively measured blood flow in the hepatic veins draining remnant liver and quantity of indocyanine green (ICG) removed in the remnant liver. We have refined this test by using a coronary sinus flow catheter, which is introduced through a internal jugular vein into the hepatic veins without difficulty.Blood flow is measured by a thermistor which is contained in the catheter, and calculated by a personal computer. The test can be carried out with accuracy in a short time.Between May 1988 and February 1991, 20 patients with a variety of diseases of the liver and biliary tract received this test and 10 of the 20 patients underwent liver resection.Postoperatively, 3 of the 10 patients presented intractable ascites, signs of encephalophathy, and jandice of the total bilirubin level of more than 5 mg/dl. In these patients, blood flow in the hepatic vein draining remnant liver was less than 300 ml/min and quantity of ICG removed was less than 0.1 mg/ml. Thus, it is necessary to select candidates with better results than these levels.

为了选择具有足够的肝脏功能储备的患者，我们在术前测量了引流残肝的肝静脉中的血流量和在残肝中去除的吲哚菁绿色（ICG）的量。我们通过使用冠状窦血流导管改进了这项测试，该导管通过颈内静脉轻松地引入肝静脉，通过导管中的热敏电阻测量血流量，并通过个人计算机计算。1988年5月至1991年2月，对20例各种肝胆疾病患者进行了这项试验，其中10例行肝切除术，术后3例出现顽固性腹水，有脑病症状，总胆红素水平> 5 mg/dl。在这些患者中，肝静脉引流残肝的血流量小于300 ml/min，ICG清除量小于0.1 mg/ml。因此，有必要选择比这些水平更好的候选人。

项目成果

都築 俊治,他: "肝癌の外科的治療 ーその適応と限界ー" 医学のあゆみ. 136. 1190-1195 (1986)

Toshiharu Tsuzuki 等人：“肝癌的手术治疗 - 其适应症和局限性”《医学史》136。1190-1195 (1986)。

Toshiharu Tsuzuki et al.: "Hepatic aesection for hepatucellular carcimoma" Surgery. 107. 511-520 (1990)

Toshiharu Tsuzuki 等人：“肝细胞癌的肝切除术”手术。

Tsuzuki T et al: "Hepatic resection for hepatocellular carcinoma." Surgery. 107(5). 511-520 (1990)

Tsuzuki T 等人：“肝细胞癌的肝切除术。”

都築俊治他: "肝癌の外科的治療ーその適応と限界" 医学のあゆみ. 136. 1190-1195 (1986)

Toshiharu Tsuzuki 等人：“肝癌的手术治疗 - 其适应症和局限性”《医学史》136。1190-1195 (1986)。

都築 俊治,他: "門脈、肝静脈、下大静脈の腫瘍血栓を有する肝癌の手術" 手術. 40. 1941-1948 (1986)

Toshiharu Tsuzuki 等人：“门静脉、肝静脉和下腔静脉内有肿瘤血栓的肝癌手术”，Surgery 40. 1941-1948 (1986)。