肝脏离段联合门静脉结扎二期肝切除术的研究进展
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张小文, Email: zhangxiaowenlu@hotmail.com

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云南省科技厅科技计划资助项目[2018FE001(-232)];昆明医科大学卓越教师建设项目青年教师培养特殊支持计划项目。


Associating liver partition and portal vein ligation for staged hepatectomy: the recent progress
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    摘要:

    术后肝功能衰竭一直是肝脏外科医生面临的一大难题,而术后肝功能衰竭往往与(FLR)不足直接相关。肝脏离段联合门静脉结扎二期肝切除术(ALPPS)作为能在短期内使FLR快速增长的一项革新技术,为因FLR不足而无法施行根治性手术的患者带来了希望。但在许多大型中心先后报道ALPPS的高病死率后,如何正确把握ALPPS手术适应证及对传统ALPPS术式的改进显得尤为重要。笔者对ALPPS促进FLR增生机制、ALPPS的病例选择、ALPPS术式的争议及目前基于经典ALPPS衍生术式的最新进展进行综述。

    Abstract:

    Postoperative liver failure has always been a difficult issue for liver surgeons, which is often directly related to the small volume of future liver remnant (FLR). The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is an innovative technique for rapid growth of FLR in a short period of time, which brings hope to those who cannot withstand a radical surgery because of insufficient volume of FLR. However, after the high postoperative mortality rates of ALPPS reported by many large medical centers, how to correctly grasp the indications of ALPPS and improve the traditional ALPPS becomes particularly important. Here, the authors address the mechanism of ALPPS promoting FLR hyperplasia, the case selection for ALPPS, the controversies regarding ALPPS and the latest progress of the derivative procedures based on the classical ALPPS.

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计凤鸣, 邹浩, 王连敏, 张小文.肝脏离段联合门静脉结扎二期肝切除术的研究进展[J].中国普通外科杂志,2019,28(1):99-106.
DOI:10.7659/j. issn.1005-6947.2019.01.014

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  • 收稿日期:2018-03-12
  • 最后修改日期:2018-08-21
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  • 在线发布日期: 2019-01-15