Extended hepatectomy in patients with hepatobiliary malignancies with and without preoperative portal vein embolization
Extended hepatectomy in patients with hepatobiliary malignancies with and without preoperative portal vein embolization
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DOI：
10.1001/archsurg.137.6.675
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发表时间：
2002-06-01
影响因子：
--
通讯作者：
Vauthey, JN
中科院分区：
文献类型：
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作者：
Abdalla, EK;Barnett, CC;Vauthey, JN
假设：术前门静脉栓塞（PVE）允许潜在的治愈性肝切除术，而不会增加肝胆恶性肿瘤患者的发病率或死亡率，这些患者是基于小肝残留尺寸的边缘候选者进行切除术。设计：对多机构数据库中接受扩展肝切除术的连续系列患者进行回顾性分析。设置：基于大学的转诊中心。患者：42例无慢性基础肝病的肝胆恶性肿瘤患者在进行扩大肝切除术（大于或等于5个肝段）之前，术前确定了未来肝残（FLR）体积。患者进行分层治疗或术前PVE.Intervention：术前经皮PVEMain结果措施：临床特征，FLR量，手术发病率，和survival.Results：有和没有接受PVE的肿瘤数量，肿瘤大小，估计失血量，手术时间，切除的复杂性，或手术切缘的组之间没有差异。接受PVE的患者的FLR明显小于未接受PVE的患者（18% vs 23%; P
Hypothesis: Preoperative portal vein embolization (PVE) allows potentially curative hepatic resection without additional morbidity or mortality in patients with hepatobiliary malignancies who are marginal candidates for resection based on small liver remnant size.Design: A retrospective review of a consecutive series of patients in a multi-institutional database who underwent extended hepatectomy.Setting: University-based referral centers.Patients: Forty-two patients underwent preoperative determination of the future liver remnant (FLR) volume before extended hepatectomy (greater than or equal to5 segments) for hepatobiliary malignancy without chronic underlying liver disease. Patients were stratified by treatment with or without preoperative PVE.Intervention: Preoperative percutaneous PVEMain Outcome Measures: Clinical characteristics, FLR volume, operative morbidity, and survival.Results: There was no difference between the groups that did and did not undergo PVE for the number of tumors, tumor size, estimated blood loss, duration of the operation, complexity of resection, or surgical margins. The FLR at presentation was significantly smaller in patients who underwent PVE than in patients who did not undergo PVE (18% vs 23%; P