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

经皮经肝门静脉栓塞术（PTPE）或肝一叶门静脉结扎造成的门静脉闭塞会导致未受累叶的肥大和再生以及受累叶的萎缩。受累叶枯否细胞数量减少。门静脉阻断后，患肝体积减小，非患肝体积增大，99 mTc-GSA摄取减少，非患肝摄取增加，而全肝摄取无变化，表明门静脉阻断使患肝功能转移到非患肝。多普勒超声显示，门静脉阻断一侧肝叶可增加肝动脉血流量。PTPE增强了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能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.