联合肝脏离断和门静脉结扎两阶段肝切除术在治疗中晚期肝癌中的应用

联合肝脏离断和门静脉结扎的两阶段肝切除术(associating liver partition and portal vein ligation for staged hepatectomy,ALPPS)是近几年提出的一种全新手术方式,因其能显著促进肝组织增生,明显缩短两次手术时间间隔,所以可用于剩余正常肝脏体积不足,不能接受大范围切除的中晚期肝癌病人。目前该术式仍存在风险和难点,有着较高的并发症发生率和病死率,短期效果尚可,但其所带来的长期存活获益尚无定论,故其发展一直伴随着诸多的争议。本文就ALPPS的相关应用进展等作一综述。

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

The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel method for treating metastatic hepatocellular carcinoma with tremendous or multiple tumors without liver cirrhosis that reported in 2012,the aim of which is to obtain a more rapid and effective increase in future liver remnant (FLR),so it is suitable for the treatment of liver tumor in which the remaining liver volume is not enough to accept a wide range liver resection.But there are still some problems.a high morbidity and a concerning high mortality.The short-term outcome of ALPPS is fair,but its long-term effect is indeterminate,which leads to a lot of controversy in the development of ALPPS.This article makes an effort to summarize the application and progress of ALPPS.