PDF(Pubmed)
Abstract：
Post hepatectomy Liver Failure (PHLF) is a fatal complication, especially after major liver resection. Insufficient remnant liver volume is a common cause of postoperative liver failure. Many strategies have been applied to induce the remnant liver hypertrophy: Portal vein embolization (PVE), PVE combined with hepatic vein embolization (LVD), two staged liver resection, Associated liver partition with portal vein ligation for staged hepatectomy (ALPPS). We present a case of a 39-year-old male patient who underwent LVD for preoperative liver hypertrophy. After LVD, the patient underwent additional artery embolization, and the patient\'s remaining liver volume increased by 63.2% in 7 weeks. The patient underwent a right hepatectomy and was discharged after 10 days, with no complications of postoperative liver failure. Simultaneous portal and hepatic vein embolization is a technique that has been applied recently because it can significantly promote the speed and extent of liver hypertrophy before major liver resection compared to portal vein embolization procedure alone. In this case, additional hepatic artery embolization may be an important factor lead to hypertrophy of the remnant liver, thereby shortening the waiting time for surgery and reducing the risk of tumor progression. Liver venous deprivation is safe and feasible to perform. Additional hepatic artery embolization may accelerate the hypertrophy of the remnant liver.
摘要：
肝切除术后肝功能衰竭（PHLF）是一种致命的并发症，尤其是在肝切除后。残肝体积不足是术后肝功能衰竭的常见原因。许多策略已被用于诱导残余肝脏肥大：门静脉栓塞（PVE），PVE联合肝静脉栓塞术(LVD),两期肝切除,相关的肝分区与门静脉结扎分期肝切除术（ALPPS）。我们介绍了一名39岁的男性患者，该患者因术前肝肥大而接受了LVD。在LVD之后,患者接受了额外的动脉栓塞，患者的剩余肝脏体积在7周内增加了63.2%。患者接受了右肝切除术,10天后出院,术后无肝功能衰竭并发症。同时门静脉和肝静脉栓塞术是最近应用的技术，因为与单独的门静脉栓塞术相比，它可以显着提高肝切除术前肝脏肥大的速度和程度。在这种情况下,附加肝动脉栓塞可能是导致残肝肥大的重要因素,从而缩短手术等待时间，降低肿瘤进展的风险。肝静脉剥夺是安全可行的。额外的肝动脉栓塞可能会加速残肝的肥大。
