门静脉栓塞术在肝脏肿瘤二期切除中的应用  

Application of portal vein embolization in the two-stage hepatectomy for liver carcinoma

作　　者：储修峰[1] Reyad Abbadi 吴志明[1] 孟兴成[1] 

机构地区：[1]中国医科大学绍兴医院肝胆外科,浙江绍兴312030 [2]英国布里斯托尔皇家医院上消化道外科

出　　处：《肝胆胰外科杂志》2013年第5期361-363,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨门静脉栓塞术在肝脏肿瘤二期切除过程中的作用与安全性。方法分析总结5例难以一期切除肝脏肿瘤,先行门静脉栓塞术后再行二期肿瘤切除患者的临床资料。所有患者均采用B超及DSA引导下经皮肝门静脉左支穿刺法对门静脉右支进行栓塞。检测门静脉栓塞术后肝功能及肝叶体积变化,总结门静脉栓塞与肿瘤二期切除手术成功率。结果 5例患者均成功实施PVE术,术后出现一过性的肝功能减退,经保肝治疗短期恢复,未栓塞侧肝脏体积代偿性增大明显,达到预期效果;所有病例均顺利完成二期肝叶切除术,术后肝功能良好。结论门静脉栓塞术成功率高、安全可行,对侧肝脏代偿性增大明显,达到预期目的,使得难以一期切除的肝脏肿瘤可以切除,从而提高肝脏肿瘤的切除率。Objective To explore the efficacy and safety of portal vein embolization （PVE） in the treatmentof liver carcinoma. Methods Five patients with liver carcinoma who were not suitable for hepatectomy at the first stage were treated by DSA-guided percutaneous transhepatic PVE with fine needles. The rate of success, the volume change of each liver lobe, and hepatectomy rate were observed. Results PVE was successfully performed in all 5 patients. The adverse reactions included transient hepatic function impairment and recovered soon. The second-stage hepatectomy was successfully completed in all patients after six weeks of PVE. No severe compli- cations occurred during therapy. Conclusion PVE is a safe and effective procedure, and it can increase the indications of hepatectomy for huge liver carcinoma and elevate the security of hepatectomy for suitable selective oatients.

关 键 词：门静脉栓塞术 肝脏肿瘤 残留肝脏体积 

分 类 号：R735.7[医药卫生—肿瘤]