The small remnant liver after major liver resection: How common and how relevant?
The small remnant liver after major liver resection: How common and how relevant?
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DOI：
10.1053/jlts.2003.50194
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发表时间：
2003-09-01
影响因子：
4.6
通讯作者：
Belghiti, A
中科院分区：
文献类型：
--
作者：
Yigitler, C;Farges, O;Belghiti, A
与安全术后结局相适应的肝切除的最大范围尚不清楚。本研究的目的是确定肝实质正常的患者在肝大部切除术后小残肝体积的发生率和影响。在265个主要的肝切除术在我们的机构（1998年至2000年），138例正常的肝脏和残肝体积（RLV）的比率系统计算的残肝体积（FLV）进行了研究。根据RLV-FLV比值从小于或等于30%到大于或等于W %将患者分为5组。术后肝功能检查的动力学与RILV相关。术后并发症按RLV-FLV比率分层。90例患者（65%）接受了最多4个Couinaud节段的切除术。94例患者（68%）的RLV-FLV比值小于或等于60%，其中仅13例（9%）的RLV-FLV小于或等于30%。切除节段数与RLV-FLV之间无线性相关性。术后血清胆红素而不是凝血酶原时间与切除范围相关。各组间并发症（包括肝衰竭）的发生率无差异。具有RLV-FLV比值的四组分析
The maximum extent of hepatic resection compatible with a safe postoperative outcome is unknown. The study goal was to determine the incidence and impact of a small remnant liver volume after major liver resection in patients with normal liver parenchyma. Among 265 major hepatectomies performed at our institution (1998 to 2000), 138 patients with normal liver and a remnant liver volume (RLV) systematically calculated from the ratio of RLV to functional liver volume (FLV) were studied. Patients were divided into five groups based on RLV-FLV ratio from less than or equal to30% to greater than or equal toW%. Kinetics of postoperative liver function tests were correlated with RILV. Postoperative complications were stratified by RLV-FLV ratios. Ninety patients (65%) underwent resection of up to four Couinaud segments. The RLV-FLV ratio was less than or equal to60% in 94 patients (68%) including only 13 (9%) with RLV-FLV less than or equal to30%. There was no linear correlation between the number of resected segments and the RLV-FLV. Postoperative serum bilirubin but not prothrombin time correlated with extent of resection. The incidence of complications including liver failure was not different among groups. Analysis of the four groups with a RLV-FLV ratio