ALPPS中肝脏离断技术变异的临床应用进展

国际肿瘤学杂志››2020,Vol. 47››Issue (8): 492-495.doi:10.3760/cma.j.cn371439-20191112-00063

ALPPS中肝脏离断技术变异的临床应用进展

刘俊国, 张金卷, 王毅军()

天津市第三中心医院肝胆外科天津市重症疾病体外生命支持重点实验室天津市人工细胞工程技术研究中心天津市肝胆研究所 300170

收稿日期:2019-11-12修回日期:2020-02-20出版日期:2020-08-08发布日期:2020-10-22
通讯作者:王毅军 E-mail:wangyijun_carl@163.com
基金资助:
天津市卫生行业重点攻关项目(15KG114);天津市科技计划(17YFZCSY01070);天津市科技计划(17ZXMFSY00050)

Clinical application progress of variations in the technique of liver partition from ALPPS

Liu Junguo, Zhang Jinjuan, Wang Yijun()

Department of Hepatobiliary Surgery, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering, Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China

Received:2019-11-12Revised:2020-02-20Online:2020-08-08Published:2020-10-22
Contact:Wang Yijun E-mail:wangyijun_carl@163.com
Supported by:
Health Industry Key Project of Tianjin(15KG114);Science and Technology Program of Tianjin of China(17YFZCSY01070);Science and Technology Program of Tianjin of China(17ZXMFSY00050)

摘要/Abstract

摘要：

联合肝脏离断和门静脉结扎的二步肝切除术(ALPPS)存在着许多技术上的变异和改良,其主要目的是降低并发症发生率和死亡率,同时可使预留残肝代偿增大更快速和功能更强健。在临床实践中,不同研究者对ALPPS中肝脏离断技术上的变异及其相关的临床结果进行了相应的研究探讨,如部分肝脏离断、门静脉结扎术辅助射频肝分割术、腹腔镜微波消融和门静脉结扎分期肝切除术、联合肝止血带和门静脉结扎分期肝切除术、续贯联合肝止血带和门静脉结扎分期肝切除术、前入路的原位肝实质离段联合门静脉栓塞二期肝切除术、门静脉栓塞代替肝脏实质离断等。

关键词:肝肿瘤,肝切除术,肝脏离断,门静脉结扎,预留残肝

Abstract:

There are many technical variations and improvements in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Its main purpose is to reduce the incidence of complications and mortality, and at the same time, the future liver remnant compensation can be increased more faster and its function becomes more robust. In clinical practice, different researchers have studied the variation and related clinical results of liver disconnection technique in ALPPS, such as partial hepatectomy, portal vein ligation assisted radio frequency hepatectomy, laparoscopic microwave ablation and portal vein ligation staged hepatectomy, combined liver tourniquet and portal vein ligation staged hepatectomy, continuous combined liver tourniquet and portal vein ligation staged hepatectomy,in situhepatectomy combined with portal vein embolization via anterior approach and portal vein embolization instead of hepatectomy separation of visceral substance,and so on.

Key words:Liver neoplasms,Hepatectomy,Associated liver partition,Portal vein ligation,Future liver remnant

刘俊国, 张金卷, 王毅军. ALPPS中肝脏离断技术变异的临床应用进展[J]. 国际肿瘤学杂志, 2020, 47(8): 492-495.

Liu Junguo, Zhang Jinjuan, Wang Yijun. Clinical application progress of variations in the technique of liver partition from ALPPS[J]. Journal of International Oncology, 2020, 47(8): 492-495.

参考文献29

[1]	Tong YF, Meng N, Chen MQ, et al. Maturity of associating liver partition and portal vein ligation for staged hepatectomy-derived liver regeneration in a rat model[J]. World J Gastroenterol, 2018,24(10):1107-1119. DOI: 10.3748/wjg.v24.i10.1107. doi:10.3748/wjg.v24.i10.1107pmid:29563755
[2]	Treska V. Methods to increase future liver remnant volume in patients with primarily unresectable colorectal liver metastases: current state and future perspectives[J]. Anticancer Res, 2016,36(5):2065-2071. pmid:27127106
[3]	Bruix J, Llovet JM. Prognostic prediction and treatment strategy in hepatocellular carcinoma[J]. Hepatology, 2002,35(3):519-524. DOI: 10.1053/jhep.2002.32089. doi:10.1053/jhep.2002.32089pmid:11870363
[4]	Schadde E, Ardiles V, Robles-Campos R, et al. Early survival and safety of ALPPS: first report of the international ALPPS registry[J]. Ann Surg, 2014,260(5):829-838. DOI: 10.1097/SLA.0000000000000947. doi:10.1097/SLA.0000000000000947pmid:25379854
[5]	Schnitzbauer AA, Lang SA, 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. DOI: 10.1097/SLA.0b013e31824856f5. doi:10.1097/SLA.0b013e31824856f5pmid:22330038
[6]	de Santibanes E, Clavien PA. Playing Play-Doh to prevent postoperative liver failure: the "ALPPS" approach[J]. Ann Surg, 2012,255(3):415-417. DOI: 10.1097/SLA.0b013e318248577d. doi:10.1097/SLA.0b013e318248577dpmid:22330039
[7]	Aloia TA, Vauthey JN. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): what is gained and what is lost?[J]. Ann Surg, 2012,256(3):e9-e19. DOI: 10.1097/SLA.0b013e318265fd3e. doi:10.1097/SLA.0b013e318265fd3epmid:22868369
[8]	Rohatgi S, Harrison EM, Powell JJ, et al. ALPPS: adverse outcomes demand clear justifification in an era of improving survival for colorectal liver metastases[J]. World J Surg, 2015,39(7):1848-1849. DOI: 10.1007/s00268-014-2726-5. doi:10.1007/s00268-014-2726-5pmid:25145819
[9]	Vauthey JN, Mise Y. Commentary on "can we improve the morbidity and mortality associated with the associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) procedure in the management of colorectal liver metastases?"[J]. Surgery, 2015,157(2):207-210. DOI: 10.1016/j.surg.2014.08.093. doi:10.1016/j.surg.2014.08.093pmid:25433731
[10]	Schlegel A, Lesurtel M, Melloul E, et al. ALPPS: from human to mice highlighting accelerated and novel mechanisms of liver regeneration[J]. Ann Surg, 2014,260(5):839-847. DOI: 10.1097/SLA.0000000000000949. doi:10.1097/SLA.0000000000000949pmid:25379855
[11]	Alvarez FA, Ardiles V, de Santibanes M, et al. Associating liver partition and portal vein ligation for staged hepatectomy offers high oncological feasibility with adequate patient safety: a prospective study at a single center[J]. Ann Surg, 2015,261(4):723-732. DOI: 10.1097/SLA.0000000000001046. doi:10.1097/SLA.0000000000001046pmid:25493362
[12]	Petrowsky H, Györi G, de Oliveira M, et al. Is partial-ALPPS safer than ALPPS? A single-center experience[J]. Ann Surg, 2015,261(4):e90-e92. DOI: 10.1097/SLA.0000000000001087. doi:10.1097/SLA.0000000000001087pmid:25706390
[13]	Tanaka K, Kikuchi Y, Kawaguchi D, et al. Modified ALPPS procedures avoiding division of portal pedicles[J]. Ann Surg, 2017,265(2):e14-e20. DOI: 10.1097/SLA.0000000000001967. pmid:27611614
[14]	Gall TM, Sodergren MH, Frampton AE, et al. Radio-frequency-assisted liver partition with portal vein ligation (RALPP) for liver regeneration[J]. Ann Surg, 2015,261(2):e45-e46. DOI: 10.1097/SLA.0000000000000607. doi:10.1097/SLA.0000000000000607pmid:24670841
[15]	Jiao LR, Fajardo Puerta AB, Gall TMH, et al. Rapid induction of liver regeneration for major hepatectomy (REBIRTH): a randomized controlled trial of portal vein embolisation versus ALPPS assisted with radiofrequency[J]. Cancers (Basel), 2019,11(3):302. DOI: 10.3390/cancers11030302. doi:10.3390/cancers11030302
[16]	Tang K, Zhang B, Dong L, et al. Successful treatment of a huge hepatic carcinoma with right portal vein rhrombosis: a case report[J]. Medicine (Baltimore), 2020,99(17):e19636. DOI: 10.1097/MD.0000000000019636. doi:10.1097/MD.0000000000019636
[17]	Gringeri E, Boetto R, D'Amico FE, et al. Laparoscopic microwave ablation and portal vein ligation for staged hepatectomy (LAPS): a minimally invasive fifirst-step approach[J]. Ann Surg, 2015,261(2):e42-e43. DOI: 10.1097/SLA.0000000000000606. doi:10.1097/SLA.0000000000000606pmid:24651131
[18]	Cillo U, Gringeri E, Feltracco P, et al. Totally laparoscopic microwave ablation and portal vein ligation for staged hepatectomy: a new minimally invasive two-stage hepatectomy[J]. Ann Surg Oncol, 2015,22(8):2787-2788. DOI: 10.1245/s10434-014-4353-7. pmid:25605516
[19]	Robles R, Parrilla P, López-Conesa A, et al. Tourniquet modifification of the associating liver partition and portal ligation for staged hepatectomy procedure[J]. Br J Surg, 2014,101(9):1129-1134. DOI: 10.1002/bjs.9547. doi:10.1002/bjs.9547pmid:24947768
[20]	Robles Campos R, Parrilla Paricio P, López Conesa A, et al. A new surgical technique for extended right hepatectomy: tourniquet in the umbilical fissure and right portal vein occlusion (ALTPS). Clinical case[J]. Cir Esp, 2013,91(10):633-637. DOI: 10.1016/j.ciresp.2013.09.004. pmid:24246509
[21]	Li J, Ewald F, Gulati A, et al. Associating liver partition and portal vein ligation for staged hepatectomy: From technical evolution to oncological benefifit[J]. World J Gastrointest Surg, 2016,8(2):124-133. DOI: 10.4240/wjgs.v8.i2.124. pmid:26981186
[22]	Cai X, Peng S, Duan L, et al. Completely laparoscopic ALPPS using round-the-liver ligation to replace parenchymal transection for a patient with multiple right liver cancers complicated with liver cirrhosis[J]. J Laparoendosc Adv Surg Tech A, 2014,24(12):883-886. DOI: 10.1089/lap.2014.0455. pmid:25387325
[23]	Robles Campos R, Brusadin R, López Conesa A, et al. Staged liver resection for perihilar liver tumors using a tourniquet in the umbilical fifissure and sequential portal vein embolization on the fourth post-operative day (a modifified ALTPS)[J]. Cir Esp, 2014,92(10):682-686. DOI: 10.1016/j.ciresp.2014.07.006. doi:10.1016/j.ciresp.2014.07.006pmid:25151854
[24]	Li J, Kantas A, Ittrich H, et al. Avoid "all-touch" by hybrid ALPPS to achieve oncological effificacy[J]. Ann Surg, 2016,263(1):e6-e7. DOI: 10.1097/SLA.0000000000000845. pmid:25072445
[25]	Cai YL, Song PP, Tang W, et al. An updated systematic review of the evolution of ALPPS and evaluation of its advantages and disadvantages in accordance with current evidence[J]. Medicine (Baltimore), 2016,95(24):e3941. DOI: 10.1097/MD.000000000-0003941. doi:10.1097/MD.0000000000003941
[26]	Lai Q, Melandro F, Rossi M. Hybrid partial ALPPS: a feasible approach in case of right trisegmentectomy and macrovascular invasion[J]. Ann Surg, 2018,267(4):e80-e82. DOI: 10.1097/SLA.0000000000002219. doi:10.1097/SLA.0000000000002158pmid:28134684
[27]	Peng SY, Wang XA, Huang CY, et al. Evolution of associating liver partition and portal vein ligation for staged hepatectomy: simpler, safer and equally effective methods[J]. World J Gastroenterol, 2017,23(23):4140-4145. DOI: 10.3748/wjg.v23.i23.4140. doi:10.3748/wjg.v23.i23.4140pmid:28694654
[28]	Xiao N, Yu K, Yu S, et al. The paradigm of tumor shrinkage and rapid liver remnant hypertrophy for conversion of initially unresec-table colorectal liver metastasis: a case report and literature review[J]. World J Surg Oncol, 2017,15(1):148. DOI: 10.1186/s12957-017-1212-6. pmid:28774330
[29]	彭淑牖, 黄从云, 李江涛, 等. 末梢门静脉栓塞术在计划性肝切除术中的应用初探[J]. 中华外科杂志, 2016,54(9):664-668. DOI: 10.3760/cma.j.issn.0529-5815.2016.09.004.