离体肝切除联合自体肝移植术在肝胆疾病中的应用  

Application of ex vivo liver resection and autotransplantation in hepatobiliary diseases

作　　者：东小鸽 王展[2] 袁加琪 刘海刚 杜凯豪 张帅[1] 侯立朝[2] DONG Xiaoge;WANG Zhan;YUAN Jiaqi;LIU Haigang;DU Kaihao;ZHANG Shuai;HOU Lizhao(Qinghai University Clinical Medical College,Xining 810001,P.R.China;Department of General Surgery,Affiliated Hospital of Qinghai University,Xining 810001,P.R.China)

机构地区：[1]青海大学临床医学院,西宁810001 [2]青海大学附属医院普通外科,西宁810001

出　　处：《中国普外基础与临床杂志》2024年第10期1265-1271,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：青海省科技厅项目(项目编号:2021-ZJ-963Q);国家自然科学基金项目(项目编号:82160131)。

摘　　要：目的对离体肝切除联合自体肝移植术(ex vivo liver resection and autotransplantation,ELRA)在肝胆疾病中的应用进行总结和分析。方法对近年来国内外ELRA用于治疗各类肝胆占位性疾病的相关文献进行全面检索及归纳总结。结果ELRA在治疗肝胆占位性疾病时,突破了传统手术操作空间小的局限,减少了对供肝的依赖,同时也避免了移植后的排斥反应。目前ELRA已在肝泡型棘球蚴病、肝癌、胆管癌及罕见肝脏占位性疾病的治疗中得到应用。结论随着ELRA技术的不断成熟和离体肝脏灌注技术的不断提高,以及严格的术前评估和精细的术后管理,ELRA术后并发症较应用初期已明显减少。严格把握手术适应证,该术式将被用于越来越多的肝胆占位性疾病的治疗。Objective To summarize and analyze the application of ex vivo liver resection and autotransplantation(ELRA)in the treatment of hepatobiliary diseases.Method The related literature about ELRA used to treat various hepatobiliary space-occupyingdiseases at home and abroad in recent years was comprehensively searched and summarized.Results ELRA had overcome the limitations of limited operational space in traditional surgery for the treatment of hepatobiliary space-occupying diseases reduced dependence on donor livers,and avoided post-transplant rejection.It had been applied in the treatment of hepatic alveolar echinococcosis,liver cancer,cholangiocarcinoma,and rare liver space-occupying diseases.Conclusions With the maturation of ELRA techniques and the continuous improvement of ex vivo liver perfusion technology,along with rigorous preoperative evaluation and meticulous postoperative management,postoperative complications of ELRA have significantly decreased compared to the initial stages of its application.By strictly adhering to surgical indications,this procedure is expected to be used treatment in an increasing number of hepatobiliary space-occupying diseases.

关 键 词：离体肝切除 自体肝移植 肝泡型棘球蚴病 肝癌 胆管癌 

分 类 号：R657.3[医药卫生—外科学]