肝门部胆管癌术前预留肝叶储备功能的评估与改善  

Evaluation and improvement of liver reserve function before hepatectomy for perihilar cholangiocarcinoma

作　　者：肖鸣 项灿宏[2] XIAO Ming;XIANG Canhong(Department of Hepatobiliary Surgery,the Second Hospital of Shandong University,Ji'nan 250033,China;Hepatopancreatobiliary Center,Beijing Tsinghua Changgung Hospital Affiliatal to Tsinghua University/Key Laboratory of Digital Intelligence Hepatology of Ministry of Education,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]山东大学第二医院肝胆外科,山东济南250033 [2]清华大学附属北京清华长庚医院肝胆胰中心/清华大学临床医学院数智肝胆病学教育部重点实验室,北京102218

出　　处：《中国普通外科杂志》2024年第12期1958-1966,共9页China Journal of General Surgery

基　　金：国家自然科学基金资助项目(82027807,81930119,82090050,82090053);中国医学科学院医学与健康科技创新工程创新基金资助项目(2019-I2M-5-056)。

摘　　要：肝门部胆管癌(PHCC)是目前最常见胆管癌类型,严重威胁我国人民的生命和健康。PHCC常伴随着胆汁淤积,肝小叶中肝细胞代谢异常,肝脏各种功能呈现不同程度的下降,肾脏、肠道等全身器官也受到影响,导致对此类患者施行肝切除手术风险较高。目前,临床现有方法无法准确地评估此类患者的区域肝脏储备功能,评估策略还有很多问题至今尚未厘清和解决。另一方面,肝切除术前促进预留肝叶增生策略及疗效存在争议。本文围绕这两个问题逐一讨论,阐述其定义、特点及进展。Perihilar cholangiocarcinoma(PHCC)is the most common type of cholangiocarcinoma and poses a serious threat to the life and health of the Chinese population.PHCC is often accompanied by bile stasis,abnormal hepatocyte metabolism within the hepatic lobules,and varying degrees of liver dysfunction.Additionally,systemic organs such as the kidneys and intestines are affected,leading to a higher risk of liver resection surgery for these patients.Currently,clinical methods are unable to accurately assess the regional liver reserve function in such patients,and many issues in assessment strategies remain unclear and unresolved.On the other hand,the strategies and efficacy of promoting hypertrophy of the future liver remnant before liver resection remain controversial.This article addresses these two issues,discussing their definitions,characteristics,and recent progress in detail.

关 键 词：Klatskin肿瘤 肝再生 肝叶储备功能 门静脉栓塞 

分 类 号：R735.8[医药卫生—肿瘤]