CAJ | 학술논문

肝脏离断联合患侧门静脉结扎二期肝切除术是一种全新的肝切除术(ALPPS).我们于2013年8月对1例68岁肝门部胆管细胞癌合并阻塞性黄疸男性患者实施了该手术.因为患者左肝外叶体积不足标准肝体积的40％(只有33.91％),我们第1步先行右侧门静脉结扎+原位离断左肝内叶和左肝外叶交界处肝组织以及肝门部淋巴结清扫术.术后第8天复查CT显示左肝外叶肝体积增加了32％,占标准肝体积的41.55％,术后第12天我们再行扩大右三叶切除+左肝管-空肠内引流术.术后三周痊愈出院.
간장리단연합환측문정맥결찰이기간절제술시일충전신적간절제술(ALPPS).아문우2013년8월대1례68세간문부담관세포암합병조새성황달남성환자실시료해수술.인위환자좌간외협체적불족표준간체적적40％(지유33.91％),아문제1보선행우측문정맥결찰+원위리단좌간내협화좌간외협교계처간조직이급간문부림파결청소술.술후제8천복사CT현시좌간외협간체적증가료32％,점표준간체적적41.55％,술후제12천아문재행확대우삼협절제+좌간관-공장내인류술.술후삼주전유출원.
Associating liver partition and portal vein ligation for two-staged hepatectomy(ALPPS) is a novel approach for hepatectomy.The case we reported was a 68 years old male patient diagnosed with hilar cholangiocellular carcinoma and obstructive jaundice.ALPPS surgery was operated.Since the patient's left lateral lobe volume was less than 40％ of the whole liver volume (merely 33.91％),the ligation of the right portal vein,plus in situ split of the junction zone between left medial and left lateral liver lobe and the dissection of portal lymph nodes as the first stage operation was conducted.Abdominal CT on the 8th day after the operation reported an increase on the volume of left lateral lobe by 32％ to 41.5％ of the whole liver volume.On the 12th day after the first stage operation,an extended right trilobate hepatectomy combined with left hepatic duct intra-jejunum drainage was performed as the second operation.The patient completely recovered and was discharged three weeks after the second stage operation.