切换至 "中华医学电子期刊资源库"

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

所属专题: 综述

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/OL]. 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/OL]. 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
[1]
de Santibañes E, Clavien PA. Playing play-doh to prevent postoperative liver failure: the "ALPPS" approach[J]. Ann Surg, 2012, 255(3):415-417.
[2]
Lang H, Baumgart J, Mittler J. Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) registry: what have we learned?[J]. Gut Liver, 2020, 14(6):699-706.
[3]
Adam R, Laurent A, Azoulay D, et al. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors[J]. Ann Surg, 2000, 232(6):777-785.
[4]
Sandström P, Røsok BI, Sparrelid E, et al. ALPPS improves resectability compared with conventional two-stage hepatectomy in patients with advanced colorectal liver metastasis: results from a Scandinavian multicenter randomized controlled trial (LIGRO trial)[J]. Ann Surg, 2018, 267(5):833-840.
[5]
Lim KC, Chow PK, Allen JC, et al. Systematic review of outcomes of liver resection for early hepatocellular carcinoma within the Milan criteria[J]. Br J Surg, 2012, 99(12):1622-1629.
[6]
Stiles ZE, Behrman SW, Glazer ES, et al. Predictors and implications of unplanned conversion during minimally invasive hepatectomy: an analysis of the ACS-NSQIP database[J]. HPB, 2017, 19(11):957-965.
[7]
陈梗, 孔一帆, 别平. 剩余肝体积不足的肝癌手术切除策略[J/OL]. 中华肝脏外科手术学电子杂志, 2020, 9(2):104-107.
[8]
Meirelles Júnior RF, Salvalaggio P, Rezende MB, et al. Liver transplantation: history, outcomes and perspectives[J]. Einstein, 2015, 13(1):149-152.
[9]
陈俊予, 庄磊, 徐克育, 等. ALPPS治疗巨大肝癌合并肝硬化[J]. 肝胆胰外科杂志, 2019, 31(10):620-623.
[10]
Shindoh J, D Tzeng CW, Vauthey JN. Portal vein embolization for hepatocellular carcinoma[J]. Liver Cancer, 2012, 1(3/4):159-167.
[11]
Aoki T, Kubota K. Preoperative portal vein embolization for hepatocellular carcinoma: consensus and controversy[J]. World J Hepatology, 2016, 8(9):439-445.
[12]
Kawaguchi Y, Lillemoe HA, Vauthey JN. Dealing with an insufficient future liver remnant: portal vein embolization and two-stage hepatectomy[J]. J Surg Oncol, 2019, 119(5):594-603.
[13]
Imai K, Allard M, Benitez C, et al. Early recurrence after hepatectomy for colorectal liver metastases: what optimal definition and what predictive factors?[J]. Oncologist, 2016, 21(7):887-894.
[14]
Chavez MI, Gholami S, Kim BJ, et al. Two-stage hepatectomy for bilateral colorectal liver metastases: a multi-institutional analysis[J]. Ann Surg Oncol, 2021, 28(3):1457-1465.
[15]
Tanaka K, Matsuo K, Murakami T, et al. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): short-term outcome, functional changes in the future liver remnant, and tumor growth activity[J]. European J Surg Oncol, 2015, 41(4):506-512.
[16]
Schnitzbauer Andreas A, Lang Sven A, Goessmann H, et al. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings[J]. Ann Surg, 2012, 255(3):405-414.
[17]
Wanis KN, Linecker M, Madenci AL, et al. Variation in complications and mortality following ALPPS at early-adopting centers[J]. HPB, 2021, 23(1):46-55.
[18]
Ratti F, Schadde E, Masetti M, et al. Strategies to increase resectability of patients with colorectal liver metastases: a multi-center case-match analysis of ALPPS versus conventional two-stage hepatectomy[J]. Ann Surg Oncol, 2015, 22(6):1933-1942.
[19]
Croome KP, Hernandez-Alejandro R, Parker M, et al. Is the liver kinetic growth rate in ALPPS unprecedented when compared with PVE and living donor liver transplant? a multicentre analysis[J]. HPB, 2015, 17(6):477-484.
[20]
林伯辉, 区奕猛. 联合肝脏离断和门静脉结扎的二步肝切除术在不可切除肝细胞癌中的应用[J].临床肝胆病杂志, 2021, 37(1):180-183.
[21]
Allaire M, Goumard C, Lim C, et al. New frontiers in liver resection for hepatocellular carcinoma[J]. JHEP Rep, 2020, 2(4):100134.
[1] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[2] 李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[3] 李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[4] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[5] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[6] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[7] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[8] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[9] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[10] 常小伟, 蔡瑜, 赵志勇, 张伟. 高强度聚焦超声消融术联合肝动脉化疗栓塞术治疗原发性肝细胞癌的效果及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 56-59.
[11] 李博, 贾蓬勃, 李栋, 李小庆. ERCP与LCBDE治疗胆总管结石继发急性重症胆管炎的效果[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 60-63.
[12] 韩戟, 杨力, 陈玉. 腹部形态CT参数与完全腹腔镜全胃切除术术中失血量的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 88-91.
[13] 王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[14] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[15] 叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?