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Outcomes of staged hepatectomies for liver malignancy

World Journal of Hepatology 2019年第6期11卷 513-521页

作者： naif a albati Ali A Korairi Ibrahim Al Hasan Helayel K Almodhaiberi Abdullah A Algarni Hepatobiliary and Liver Transplant Unit Department of General Surgery Prince Sultan Military Medical City

Liver malignancies are the fifth most common cause of death worldwide.Surgical intervention with curative intent is the treatment of choice for liver tumors as it provides long-term survival.However,only 20%of patients with metastatic liver lesions can be managed by curative liver resection.In most of the cases,hepatectomy is not feasible because of insufficient future liver remnant(FLR).Two-stage hepatectomy is advocated to achieve liver resection in a patient who is considered to not be a candidate for resection.Procedures of staged hepatectomy include conventional two-stage hepatectomy,portal vein embolization,and associating liver partition and portal vein ligation for a staged hepatectomy.Technical success is high for each of these procedures but variable between them.All the procedures have been reported as being effective in achieving a satisfactory FLR and completing the second-stage resection.Moreover,the overall survival and disease-free survival rates have improved significantly for patients who were otherwise considered nonresectable;yet,an increase in the morbidity and mortality rates has been observed.We suggest that this type of procedure should be carried out in high-flow centers and through a multidisciplinary approach.An experienced surgeon is key to the success of those interventions.

关键词： Staged hepatectomy Portal vein embolization Portal vein ligation Colorectal liver metastasis Hepatocellular carcinoma Associated liver partition and portal vein ligation for staged hepatectomy

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