联合肝脏离断和门静脉结扎二步肝切治疗原发性肝细胞癌1例报告并文献复习.pdfVIP

·668· 中国实用外科杂志 2015 年6 月 第 35 卷 第 6 期 论 著 文章编号：1005-2208（2015）06-0668-05 DOI:10.7504/CJPS.ISSN1005-2208.2015.06.22 联合肝脏离断和门静脉结扎二步肝切除术治疗 巨大原发性肝细胞癌1例报告并文献复习 施化文，陆朝阳，张树庚，尹大龙，郑桐森，孙博实，姜洪池，刘连新 【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 中图分类号：R6 文献标志码：A 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@ To investigate the efficacy and safety of associating liver partition and portal vein ligation for Abstract Objective staged hepatectomy (ALPPS) in the treatment of huge primary hepatocellular carcinoma. The clinical data of Methods 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 iso