【摘要】 目的通过对实施ALPPS手术的3例伴肝硬化巨大肝癌(平均肿瘤直径12.6 cm)患者资料的分析,初步探讨其利弊。方法回顾性分析笔者所在医院3例实施ALPPS手术患者的资料,通过对术前评估、术中及术后的治疗要点分析以探讨其利弊。结果 1例因肝功能衰竭死亡,另外2例存活至今。死亡病例第2次术后MELD评分最高升至18.8分,另外2例第2次术后MELD评分均下降。肝脏体积平均增加225 m L,2次手术前相比,肝脏体积明显增加(P=0.002)。结论 ALPPS使得一部分伴肝硬化的巨大肝癌患者获得手术切除的机会,但应综合考虑患者术前状态、评估手术风险、预后判断以及经济状况来决定患者能否从ALPPS获益更多。更多还原

【Abstract】 Objective To explore it’s advantages and disadvantages through analyzed the data of associating liver partition with portal vein ligation for staged hepatectomy(ALPPS) operation in 3 cases of liver cancer patients with cirrhosis.Methods The data of 3 patients perfomed ALPPS operation were retrospectively analyzed,through the preoperative evaluation,intraoperative and postoperative treatment points analyzed to explore the pros and cons.Results One case died of hepatic failure,and the remaining two cases were still alive.The highest score of MELD of liver failure in death case was 18.8 scores,and the other cases of MELD score were decreased after second operation.The average increased volume of liver was 225 mL,and the liver volume was significantly increased(P=0.002).Conclusions ALPPS make a portion of huge liver cancer patients combining with cirrhosis having a chance to surgery.But it is necessary to consider in patients with preoperative state,surgical risk,prognosis and economic conditions,in order to determine whether patients can benefit from ALPPS.更多还原