联合肝脏离断和门静脉结扎的二步肝切除术在肝脏肿瘤治疗中的应用

联合肝脏离断和门静脉结扎的二步肝切除术（ALPPS）是近年提出的一种手术方式,分两次完成,第1次手术包括门静脉结扎、在待切除肝和需保留肝之间离断肝实质,待剩余肝脏体积增大后再行第2次手术切除病肝。ALPPS主要目的是使剩余肝脏体积快速增长,为那些原来不能切除的肝脏恶性肿瘤的患者提供可根治性切除的机会。本文综述了近几年ALPPS方面的研究,从演变过程、手术方法、适用范围、存在争论的问题和近几年的研究现状等方面进行了总结和分析,并对以后的发展方向提出了展望。

Application of associating liver partition and portal vein ligation for staged hepatectomy in curing liver neoplasms

Associating liver partition and portal vein ligation for staged hepatectomy（ALPPS）is a surgical technique reported in 2012, the aim of which is to obtain a more rapid and effective increase in future liver remnant（FLR）. The first stage of ALPPS has combined portal vein ligation and in situ parenchymal transection for right hepatectomy or trisectionectomy. After an interval of several days, stage II will be performed to remove the diseased liver. It＇s the volume of FLR that makes an important factor that lowers the resectability of primary or secondary hepatic malignancies. This review has summarized studies in recent years to introduce the applications of ALPPS from the following aspects： surgical methods, indications, points at issue, current situations of research, in order to reveal the promising future of ALPPS.