Abstract:

Associating liver partition and portal vein ligation for staged hepatectomy in the treatment of huge primary hepatocellular carcinoma: A report of 1 case and review of literatures        SHI Hua-wen，LU Zhao-yang，ZHANG Shu-geng，et al. Department of Hepatic Surgery，the First Affiliated Hospital of Harbin Medical University，Harbin 150001，China
Corresponding author：LIU Lian-xin，E-mail：liulianxin@medmail.com.cn
Abstract    Objective    To investigate the efficacy and safety of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in the treatment of huge primary hepatocellular carcinoma. Methods    The clinical data of one case of huge right-lobe primary hepatocellular carcinoma and portal vein of three branches who had been successfully performed an ALPPS in December 2014 in the First Affiliated Hospital of Harbin Medical University was analyzed retrospectively. In the first stage, two branches of the right portal vein branch were ligated and subsequently the liver parenchyma was dissected along the falciform ligament to isolate the segment Ⅳ and the left lateral lobe in the first stage. In the second stage，the extended right lobe was removed. Results    On the seventh day after the first stage，the remnant liver volume increased from 281mL to 606mL and liver function was returned to normal on the seventh day. On the eighth day after the first stage，the second staged operation was performed and liver function was returned to normal on the fifth day. Conclusion    ALPPS brings a new choice for patients with huge hepatocellular carcinoma with insufficient future liver remnant.

Key words: huge primary hepatocellular carcinoma, associating liver partition and portal vien ligation for staged hepatectomy, liver volume assessment

摘要：

目的    探讨联合肝脏离断和门静脉结扎的二步肝切除术（ALPPS）治疗巨大原发性肝细胞癌的安全性及有效性。方法    回顾性分析2014年12月哈尔滨医科大学附属第一医院行ALPPS的１例右肝巨大肝细胞癌并门静脉三个分支病人的临床资料，第一步手术结扎门静脉右支并原位劈离肝左外叶和左内叶，第二步行肝脏右三叶切除术。结果    第一步手术7 d后，剩余肝脏体积由术前281 mL增加至606 mL，术后第7天肝功能恢复正常。第一步术后第8天行第二步手术，术后第5天肝功恢复正常。结论    ALPPS为残余肝脏体积不足的巨大肝癌病人提供了新的治疗选择。

关键词: 巨大原发性肝细胞癌, 联合肝脏离断和门静脉结扎的二步肝切除术, 肝脏体积评估