中国实用外科杂志

中国实用外科杂志

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肝静脉剥夺术——残余肝脏不足时手术新思路

王明宇1，梁英健1，尹    兵1，惠    鹏1，刘连新1，2   

  1. 1 哈尔滨医科大学附属第一医院肝脏外科，黑龙江哈尔滨 150001；2中国科学技术大学附属第一医院（安徽省立医院）肝胆外科，安徽合肥 230001
  • 出版日期:2020-01-01 发布日期:2020-01-16

  • Online:2020-01-01 Published:2020-01-16

摘要： 肝静脉剥夺术（liver venous deprivation，LVD）是近年来两步法肝切除最新开展的手术方式，以联合应用门静脉栓塞（portal vein embolization，PVE）和肝静脉栓塞（hepatic vein embolization，HVE）的方式来达到使残余肝脏（future liver remnant，FLR）快速增生的目的。LVD相比于之前开展的单纯PVE和联合肝脏分隔和门静脉结扎二步肝切除术（associating liver partition and portal vein ligation for staged hepatectomy，ALPPS），在达到了FLR迅速增生的同时，对病人造成更小的损伤，其并发症发生率和病死率也远远低于ALPPS。这也使得更多的肝脏恶性肿瘤病人获得了R0切除的机会。

关键词: 肝脏, 肝静脉剥夺术, 门静脉栓塞术, 联合肝脏分隔和门静脉结扎二步肝切除术

Abstract: New way of operation for insufficient volume of future liver remnant——liver venous deprivation        WANG  Ming-yu*, LIANG  Ying-jian, YIN Bing,et al. Department of Liver Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China
Corresponding author: LIU  Lian-xin, E-mail：liulianxin@
medmail.com.cn
Abstract    In recent years, liver venous deprivation(LVD) is the latest two-stage hepatectomy.The combination of portal vein embolization(PVE) and hepatic venous embolization(HVE) is used to achieve the purpose of rapid growth of future liver remnant(FLR).Compared with PVE and associated liver partition and portal vein ligation for staged hepatectomy (ALPPS), LVD can cause less damage to patients when it reaches the rapid growth of FLR, and its complication rate and mortality are far lower than ALPPS. This also makes more patients with liver cancer get the chance of R0 resection. In this paper, the research of LVD in recent years is reviewed, its development history, operation mode, mechanism, advantages and disadvantages are analyzed and summarized, and its application prospect is discussed.

Key words: liver;liver venous deprivation;portal vein embolization, associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)