肝脏增大:理由,现状和未来方向
Jirapa Chansangrat1, Sameer Gadani2
1Section of Interventional Radiology, Imaging institute, Cleveland Clinic, Cleveland, OH; School of Radiology, Medical Institute, Suranaree University of Technology, Nakhon Ratchasima, Thailand.
Techniques in vascular and interventional radiology
|November 16, 2025
概括
像PVE和ALPPS这样的肝脏增大技术增强了未来的肝脏残留物 (FLR),使肝癌患者的手术成为可能. 这些方法改善了结果,减少了并发症,改变了肝癌管理.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术瘤学手术瘤学
- 再生医学是一种再生医学.
背景情况:
- 肝脏增大技术对于管理原发性肝癌和转移至关重要,特别是当未来的肝脏残留物 (FLR) 不足时.
- 这些技术旨在预防肝切除术后肝衰竭 (PHLF),这是肝切除术后死亡的重要原因.
- 现有的方法包括门静脉栓塞 (PVE),肝静脉剥夺 (LVD),以及分阶段肝切除术 (ALPPS) 的肝脏分割和门静脉结合.
研究的目的:
- 审查肝脏癌症管理肝脏增强技术的进展.
- 探索增加未来肝脏残留物 (FLR) 体积和功能的方法.
- 讨论功能评估工具的作用和患者选择和结果预测中的新兴创新.
主要方法:
- 审查已建立的肝脏增大技术 (PVE,LVD,ALPPS).
- 讨论功能评估工具 (肝胆镜,MRI与肝细胞特异性对比).
- 探索影响肝脏再生的因素和瘤特异性考虑.
- 在体积评估中包括人工智能等新兴创新.
主要成果:
- 肝脏增大技术通过诱导FLR缩,使以前无法手术的患者能够进行治疗性手术.
- 功能评估工具有助于预测术后结果和评估肝功能.
- 针对肝细胞癌和胆道恶性瘤等特定疾病需要量身定制的方法.
- 人工智能显示出增强体积评估和患者选择的潜力.
结论:
- 肝脏增强方面的进步扩大了肝癌患者的外科治疗资格.
- 这些技术可以改善瘤的结果,并减少术后并发症.
- 肝脏增大代表了管理肝癌的变革性方法,为患者提供更好的治疗结果.
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