术前选择性门静脉栓塞在大肠癌肝转移患者中的应用

Application of preoperative portal vein embolization in colorectal cancer liver metastases

大肠癌多发性肝转移灶切除后剩余肝脏组织太少,易导致术后肝功能不全或肝功能衰竭,限制了手术的应用。术前门静脉栓塞术(PVE)通过使栓塞侧肝叶萎缩,诱使对侧肝叶代偿性增生肥大,使原来不能耐受肝切除的患者能够安全地接受手术治疗。现综述术前选择性门静脉栓塞术在大肠癌肝转移应用中的病理生理学基础、临床适应证及疗效。

Patients are expected to have small liver remnant volume （FLR） with associated risk of postoperative liver insufficiency or liver failure after curative resection of multiple hepatic metastases from colorectal cancer,which excludes many patients from surgical treatment. Preoperative portal vein embolization （PVE） induces ipsilateral atrophy as well as contralateral compensatory hypertrophy of the residual liver, thus makes the patients undergo surgical resection safely. This review will focus on pathophysiological mechanism, clinical indication ,and efficacy of PVE in colorectal cancer liver metastases.