论文部分内容阅读
目的探讨术前门静脉栓塞(portal vein embolization,PVE)在Ⅳ型肝门胆管癌中的应用价值。方法对2010年12月至2011年2月中国医科大学附属盛京医院肝胆脾外科术前行PVE的2例Ⅳ型肝门胆管癌进行分析。结果 2例均行经皮经肝胆道引流(percutaneous transhepatic biliary drainage,PTBD)解除梗阻性黄疸,PVE诱导剩余肝体积代偿增生后,未来剩余肝(future liver remnant,FLR)与全肝体积(total liver volume,TLV)之比分别为49.7%、43.7%,较PVE前分别增加7.9%,5.4%。2例行右半肝及尾状叶切除、肝门胆管癌根治术,手术顺利,术后恢复良好,至今分别无瘤生存18、19个月。结论 PVE能够安全有效增加FLR,从而增加手术安全性,降低术后肝衰竭的发生率。
Objective To investigate the value of preoperative portal vein embolization (PVE) in type Ⅳ cholangiocarcinoma. Methods From December 2010 to February 2011, 2 cases of type Ⅳ hilar cholangiocarcinoma were treated with PVE in Shengjing Hospital of China Medical University. Results Two cases were treated with percutaneous transhepatic biliary drainage (PTBD) to relieve obstructive jaundice. After PVE induced compensatory hyperplasia of residual liver volume, future liver remnant (FLR) and total liver volume volume, TLV) were 49.7% and 43.7% respectively, up 7.9% and 5.4% respectively compared with those before PVE. 2 cases of right hepatic and caudate lobe resection, radical hilar cholangiocarcinoma, surgery was successful, good recovery after surgery, so far respectively tumor-free survival 18,19 months. Conclusions PVE can increase FLR safely and effectively, which can increase the safety of operation and reduce the incidence of postoperative liver failure.