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首页> 外文期刊>Journal of hepato-biliary-pancreatic surgery >Assessment of hepatic reserve for the indication of hepatic resection.
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Assessment of hepatic reserve for the indication of hepatic resection.

机译：评估肝储备以指示肝切除。

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The main goal of liver resection in patients with liver tumor is to cure the patients with the lowest operative risk. Based on our experiences, we report herein, indications of liver resection according to the nature of underlying liver parenchyma. In patients with normal underlying liver parenchyma, major resection does not require specific preoperative assessment. Non-tumorous biopsy is indicated in cases of massive steatosis and/or in patients in whom a complex technical procedure is anticipated. Portal vein embolization (PVE) is considered if the future liver remnant (FLR) is < 30%. In patients with chronic liver disease, major hepatectomy is a risky situation, requiring specific preoperative assessment, including non-tumorous biopsy and PVE which could be associated with transarterial chemoembolization. Absence of hypertrophy of the FLR after PVE is a contraindication to a major hepatectomy. Intraoperative procedures in patients "at risk" require specific techniques, including intermittent clamping, anterior approach with hanging maneuver, and fixation on anatomical position of the remnant liver.
机译：肝肿瘤患者肝切除的主要目的是治愈手术风险最低的患者。根据我们的经验，我们在此报告根据基本肝实质的性质进行肝切除的指征。对于基础肝实质正常的患者，大手术不需要进行特殊的术前评估。在严重脂肪变性和/或预期复杂技术过程的患者中，建议进行非肿瘤活检。如果未来的肝残余（FLR）小于30％，则应考虑门静脉栓塞（PVE）。在患有慢性肝病的患者中，大肝切除术是一个危险的情况，需要进行特殊的术前评估，包括非肿瘤活检和可能与经动脉化疗栓塞有关的PVE。 PVE后FLR肥大缺乏是大肝切除术的禁忌证。对处于“高危”状态的患者进行术中手术需要特定的技术，包括间歇性钳夹，采用悬吊动作的前入路以及固定在残余肝脏的解剖位置上。

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