联合肝脏分隔和门静脉结扎的二步肝切除术的现状与挑战

Present and future for associating liver partition and portal vein ligation for staged hepatectomy

与门静脉栓塞术和传统二步肝切除术比较，联合肝脏分隔和门静脉结扎的二步肝切除术（ALPPS）能诱导肝赃快速增生，但同时也伴随着围术期高并发症发生率和死亡率。随着各种ALPPS手术技术的改良以及经验的积累，其安全性已有所提高，但仍有较大提高空间。ALPPS治疗恶性肿瘤的中、远期疗效尚缺乏长期随访结果。此外，ALPPS诱导肝脏快速增生的机制目前尚不明确，有待进一步研究。

Compared to traditional two-stage hepateetomy, portal vein embolization and associating liver partition and portal vein ligation for staged hepatectomy （ALPPS） can induce the proliferation of liver rapidly, concomitantly with high incidence of complications and mortality in the perioperative period. The feasibility and safety have been improved gradually as the improvement of technology and the accumulation of experience. But it is still controversial on its efficacy for malignant tumors, especially with insufficiency of medium- and long-term outcomes. The mechanism of rapid proliferation induced by ALPPS needs more studies with further steps.