The first case of liver resection combined with ligation of portal vein in two patients

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The day before, the successful implementation of the first Department of hepatobiliary surgery in our region combined liver interruption and

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The day before, the successful implementation of the first Department of hepatobiliary surgery in our region combined liver interruption and portal vein ligation two hepatectomy (ALPPS), marking the Department of hepatobiliary surgery in our hospital, the overall strength has stepped on a new stage, treatment of liver cancer has reached the international advanced level, but also for huge hepatocellular carcinoma with new cure I hope.

Mr. Qin due to sudden abdominal pain were diagnosed as primary liver cancer in June 2014 admitted to the Department of hepatobiliary surgery in our hospital ward two. Due to the large size (diameter about 20cm), occupy the right lobe of the liver, if according to the traditional method for resection of liver cancer patients, most likely because of residual liver volume is too small, resulting in life-threatening postoperative liver failure occurred. In our department chief expert Li Lequn under the leadership of Dean, carefully review the relevant literature at home and abroad, the organization of hepatobiliary surgery wards and two wards of the expert consultation discussion, decided to step off and two hepatic portal vein ligation for patients with combined liver resection. Department of hepatobiliary surgery team for the patient to develop a careful program of surgery and perioperative treatment program, under the guidance of the director of the Department of Li Ying, the operation by the chief physician Bond and deputy director of the implementation of the physician, Dr. Zhang Zhiming. The operation was divided into two phases according to the plan. The first stage of the operation was to separate the hepatic tissue between the left lobe and right lobe of the liver. At the first thirteenth days after operation, the liver volume was measured by three dimensional liver surgery planning system. It was found that the left lobe volume was increased by about 200% compared with that before operation. So on the fourteenth day the patient was once again pushed into the operation room, the doctor for the patient underwent a two stage surgery, complete removal of the giant tumor of 3kg. After the operation, the patients had good liver function.

According to Dean Li Lequn introduction, in 2008 the German liver surgery experts to implement the world's first ALPPS, so far the literature reports the implementation of such operations around the world more than 100 cases. This procedure is suitable for patients with large liver tumors, while the residual liver volume is too small. In the first period after the surgery, the tumor side of the liver volume due to decreased blood flow and residual liver atrophy, because blood flow increased and increased rapidly, the residual liver volume large enough after the two stage operation, so as to ensure that the liver tumor resection and can prevent postoperative liver failure. But President Li also pointed out that because the patient must undergo a two operation in the short term, the operation risk was significantly increased, liver surgery need to have rich experience, but also need the Department of Anesthesiology and ICU, imaging disciplines multidisciplinary collaboration.

 

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