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中华肝脏外科手术学电子杂志 ›› 2023, Vol. 12 ›› Issue (03) : 345 -347. doi: 10.3877/cma.j.issn.2095-3232.2023.03.019

病例报告

腹腔镜下ALPPS右半肝切除一例(附视频)
郭佳胤1, 徐杰1, 刘作金1,()   
  1. 1. 400010 重庆医科大学附属第二医院肝胆外科
  • 收稿日期:2023-02-20 出版日期:2023-06-10
  • 通信作者: 刘作金

Laparoscopic ALPPS of right lobe: report of one case (video attached)

Jiayin Guo1, Jie Xu1, Zuojin Liu1()   

  • Received:2023-02-20 Published:2023-06-10
  • Corresponding author: Zuojin Liu
引用本文:

郭佳胤, 徐杰, 刘作金. 腹腔镜下ALPPS右半肝切除一例(附视频)[J]. 中华肝脏外科手术学电子杂志, 2023, 12(03): 345-347.

Jiayin Guo, Jie Xu, Zuojin Liu. Laparoscopic ALPPS of right lobe: report of one case (video attached)[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(03): 345-347.

ALPPS是2007年由Baumgar教授首次提出,其最初是为了防止术后残肝体积不足而采取的一种方法,主要适用于一侧肿瘤需要行右三叶切除或两侧肝脏多发肿瘤而残肝体积不足的患者[1,2]。ALPPS的出现也不是一蹴而就的,而是外科医师在一步步实践中逐步发展形成,其实质就是传统的二步肝切除方法(two-stage hepatectomy)[3]。我国是肝细胞癌(肝癌)大国,每年约有30万人因肝癌死亡[4]。由于肝癌发病的隐匿性,许多初诊患者已丧失手术机会,ALPPS对于此类残肝体积不足的患者提供了一种新的手术方式,让患者获得治疗的机会。重庆医科大学附属第二医院于2022年5月行腹腔镜下ALPPS成功治疗1例肝癌合并肝右静脉受侵的患者,术后恢复良好,现报道如下。

图1 一例肝癌合并肝右静脉受侵患者第一次CT及三维重建注:a为动脉期;b为门静脉期;c为三维重建
图2 一例肝癌合并肝右静脉受侵患者ALPPS第二次术前影像及术后标本注:a为CT门静脉期;b为CT三维重建;c为完整切除的右半肝和肿瘤
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