联合肝脏离断和门静脉结扎的二步肝切除术治疗合并较重肝硬化肝癌1例  

Associating liver partition and portal vein ligation for staged hepatectomy in a hepatocellular carcinoma patient with severe liver cirrhosis

作　　者：刘静[1] 陈永艺[1] 曾荣耀[1] 徐政[1] 姚志华[1] 陈艺辉[1] 柯恩明[1] 谢宝强[1] 周水添[2] 

机构地区：[1]中国人民解放军第175医院(厦门大学附属东南医院)普外科,福建省漳州市363000 [2]中国人民解放军第175医院(厦门大学附属东南医院)放射科,福建省漳州市363000

出　　处：《世界华人消化杂志》2015年第6期1038-1044,共7页World Chinese Journal of Digestology

基　　金：2011年度南京军区医学科技创新基金资助项目;No.11MA082~~

摘　　要：我国肝癌患者就诊时多数处于中晚期.联合肝脏离断和门静脉结扎的二步肝切除术(associating liver partition and portal vein ligation for staged hepatectomy,ALPPS)是当前的创新手术方式,国外多用于治疗无肝病基础的巨大或多发的转移性肝癌的治疗.本例用ALPPS成功地治疗合并较重肝硬化的巨大肝细胞癌.介绍了术中联合防黏连膜肝周隔绝和肝动脉和门静脉放置治疗泵,经治疗泵注射含血管内皮抑素化疗栓塞乳剂防治肿瘤复发的方法.随访3 mo未见复发.Associating liver partition and portal vein ligation for staged hepatectomy （ALPPS） is a novel method fbr treating metastatic hepatocellular carcinoma （HCC） with tremendous or multiple tumors without liver cirrhosis. Here we report that ALPPS was used successfully in a man with huge HCC in the left lobe of the liver complicated with severe liver cirrhosis. Absorbable antistick film around remnant liver was inserted and drug delivery systems （DDS） to proper hepatic artery and portal vein were respectively embedded in the second step to reduce HCC relapse by chemoembolization with emulsion including Endostar through the two DDS. Relapse of HCC was not found three months after surgery.

关 键 词：肝细胞肝癌 肝硬化 二步肝切除术 门静脉 离断 防黏连膜 

分 类 号：R735.7[医药卫生—肿瘤] R657.31[医药卫生—临床医学]