DEVELOPMENT OF PORTAL OCCLUSION AS MULTIDICPLINARY TREATMENT AND ITS CLINICAL USE FOR ADVANCED HEPATOCELLULAR CARCINOMA

经皮肝门静脉栓塞术（PTPE）或肝单叶门静脉结扎术阻断门静脉会导致未受累的肝叶肥大和再生，而受累的肝叶萎缩。受累肺叶的库普弗细胞数量减少。在人类中，门静脉闭塞后，受累肺叶的体积减小而未受累肺叶的体积增大。门静脉occ后，受累肺叶99mTc-GSA摄取减少，未受累肺叶99mTc-GSA摄取增加；而全肝的摄取没有改变，表明门静脉闭塞使病变叶的功能转移到非病变叶。多普勒超声显示单叶门静脉闭塞使肝动脉血流量增加。PTPE可增强经导管动脉栓塞治疗肝癌的抗癌作用。门静脉阻断联合肝动脉灌注化疗是治疗不可切除肝癌的有效方法。

Portal occlusion by percutaneous transhepatic portal vein embolization (PTPE) or portal ligation of the one lobe of the liver causes hypertrophy and regeneration of the non-affected lobe and atrophy of the affected lobe. The number of Kuppfer cells in the affected lobe decreased. In humans, the volume of the affected lobe decreased and that of the non-affected lobe increased after the portal occlusion.Uptake of 99mTc-GSA in the affected lobe decreased and that of the non-affected lobe increased after the portal occ ; usion, whereas the uptake of the total liver did not change, indicating that the portal occlusion shifts the function of the affected lobe to the non-affected lobe. Doppler sonography showed that portal occlusion of the one lobe increase the arterial blood flow of the liver. PTPE strengthens the anticancer effect of transcatheter arterial embolization for hepatocellular carcinoma. The combination of portal occlusion and hepatic arterial infusion chemotherapy is effective for unresectable hepatocellular carcinoma.