Feasibility of combining liver dissection and portal vein ligation two-step hepatectomy for massive liver tumors
Objective To explore the feasibility of associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)for massive liver tumors and summarize the treatment experiences.Method From January 2019 to March 2024,the relevant clinical data were retrospectively reviewed for 3 patients of massive liver tumors undergoing ALPPS.The perioperative data and operative findings were evaluated.Results Three patients had tumor diameters of 11.0 cm×14.0 cm,13.0 cm×15.5 cm and 16.5 cm×19.0 cm respectively.All of them underwent ALPPS successfully and there was no surgical mortality.Enhanced computed tomography(CT)re-examinations at Day 7 after ALPPS stage-Ⅰ revealed atrophy(n=2)at tumor-bearing side and hyperplasia at reserved side(64.41％vs.72.38％).One case showed no significant enlargement of preserved lateral liver lobe and remedial hepatic artery embolization(HAE)was performed.Future residual liver(FLR:residual liver volume/functional liver volume)was measured by enhanced CT at Day 14.After simulated right half liver/right trillobectomy,FLR was 51.27％,62.33％and 46.48％.There were biliary leakage after ALPPS stage-Ⅰ(n=1)and chest and abdominal effusion after ALPPS stage-Ⅱ(n=2).Alanine transaminase,total bilirubin and other indices became transiently elevated and normalized at Day 6.Alpha-fetoprotein(AFP)was＜20.0 μg/L.All of them recovered and were smoothly discharged from hospital.Conclusion ALPPS may induce a rapid immediate proliferation of reserved liver lobes,lower the risk of postoperative liver failure in massive liver tumors and expand the limit of radical resection of liver tumors.It is recommended for massive liver tumors.
Associated liver partition and portal vein ligation for staged hepatectomyMassive liver tumorsComplication
万方数据
维普
