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首页> 外文期刊>Updates in Surgery >Role of portal vein embolization in liver surgery: single centre experience in sixty-two patients
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Role of portal vein embolization in liver surgery: single centre experience in sixty-two patients

机译：门静脉栓塞术在肝手术中的作用：62名患者的单中心经验

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摘要

The extent of liver resection is limited by the residual functional reserve of the liver (FLR). The introduction of portal vein embolization (PVE), with the rationale of inducing hypertrophy of the FLR has significantly reduced morbidity and in particular the impact of postoperative liver failure (PLF). The objective of the study is to evaluate the feasibility and effectiveness of PVE in patients candidates to liver resections with high risk of PLF. Between January 2006 and December 2009, 62 patients suffering from primary or metastatic liver tumour, underwent PVE at the Department of Surgery–Liver Unit HSR. CT assessment of hepatic volume was performed in each patient, prior and 4 weeks after the procedure. The outcome was evaluated in terms of feasibility of surgery, FLR growth [calculated as: (FLR after PVE ? FLR pre PVE) × 100/FLR pre PVE], morbidity and mortality associated with PVE and surgery. Of the 62 patients undergoing PVE, 6 (9.7%) did not benefit from surgery: of these, 4 showed spread of disease in the FLR at CT control, while in the remaining 2 adequate hypertrophy was not reached. The average volume of the FLR at the time of the procedure and after 4 weeks was 437.03 cc (±172.54) and 615.15 cc (± 187.49), respectively, with an average increase of 50.3% (±30.31). During the postoperative period, only 2 patients (3.2%) showed mild and transient signs of the PLF. The technique of PVE allows to performing, in an effective and safe way, major liver resections in patients with high risk of PLF.
机译：肝脏切除的程度受到肝脏残余功能储备（FLR）的限制。引入门静脉栓塞术（PVE）以及诱导FLR肥大的原理已大大降低了发病率，尤其是术后肝衰竭（PLF）的影响。这项研究的目的是评估PVE在具有高PLF风险的肝切除患者中的可行性和有效性。在2006年1月至2009年12月之间，有62例患有原发性或转移性肝肿瘤的患者在外科SSR肝病部门HSR接受了PVE。在手术前和手术后4周对每位患者进行肝体积的CT评估。根据手术的可行性，FLR的增长[计算为：（PVE后的FLR≥PVE之前的FLR）×100 / PVE之前的FLR]，与PVE和手术相关的发病率和死亡率评估结局。在接受PVE的62例患者中，有6例（9.7％）没有从手术中受益：其中4例在CT控制下FLR显示疾病扩散，而其余2例则未达到足够的肥大。手术时和治疗4周后，FLR的平均体积分别为437.03 cc（±172.54）和615.15 cc（±187.49），平均增加50.3％（±30.31）。术后只有2例患者（3.2％）表现为轻度和短暂的PLF征象。 PVE技术允许以高效率和安全的方式对具有高PLF风险的患者进行大型肝切除术。

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  • 来源
    《Updates in Surgery》 |2010年第4期|153-159|共7页
  • 作者

    Francesca Ratti; Corrado Soldati; Marco Catena; Michele Paganelli; Gianfranco Ferla; Luca Aldrighetti;

  • 作者单位

    Dipartimento di Chirurgia Generale e Specialistica Unità Operativa Complessa Chirurgia Epatobiliare Liver Unit IRCCS H San Raffaele Università Vita-Salute S. Raffaele Via Olgettina 60 20132 Milan Italy;

    Unità di Radiologia Diagnostica e Interventistica IRCCS H San Raffaele Università Vita-Salute S.Raffaele Via Olgettina 60 20132 Milan Italy;

    Dipartimento di Chirurgia Generale e Specialistica Unità Operativa Complessa Chirurgia Epatobiliare Liver Unit IRCCS H San Raffaele Università Vita-Salute S. Raffaele Via Olgettina 60 20132 Milan Italy;

    Dipartimento di Chirurgia Generale e Specialistica Unità Operativa Complessa Chirurgia Epatobiliare Liver Unit IRCCS H San Raffaele Università Vita-Salute S. Raffaele Via Olgettina 60 20132 Milan Italy;

    Dipartimento di Chirurgia Generale e Specialistica Unità Operativa Complessa Chirurgia Epatobiliare Liver Unit IRCCS H San Raffaele Università Vita-Salute S. Raffaele Via Olgettina 60 20132 Milan Italy;

    Dipartimento di Chirurgia Generale e Specialistica Unità Operativa Complessa Chirurgia Epatobiliare Liver Unit IRCCS H San Raffaele Università Vita-Salute S. Raffaele Via Olgettina 60 20132 Milan Italy;

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  • 关键词

    Liver surgery; Portal vein embolization; Liver failure;

    机译：肝手术;门静脉栓塞;肝功能衰竭;

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