肝Ⅶ、Ⅷ段切除联合肝右静脉切除重建治疗原发性肝癌1例暨文献复习

LiverⅦandⅧSegmental Resection Combined with Right Hepatic Vein Resection and Reconstruction for Primary Liver Cancer:A Case Report and Literature Review

目的探讨同种异体血管移植技术用于肝静脉受累的原发性肝癌根治术中的近期疗效。方法介绍湖南师范大学附属第一医院(湖南省人民医院)采用肝Ⅶ、Ⅷ段切除联合肝右静脉切除、同种异体血管重建术治疗1例原发性肝癌患者的临床经验。结果经严格术前评估后,行肝Ⅶ、Ⅷ段切除联合肝右静脉切除、同种异体血管重建术,术中超声示肝右静脉血流通畅,术后无胆漏、出血、感染等并发症发生,规律服用抗病毒及靶向药物治疗,患者目前仍在随访中,已无瘤生存13个月。结论同种异体血管重建术用于肝静脉受累的原发性肝癌根治术,术后规律靶向治疗,近期效果良好,具有较高的临床应用价值;同种异体静脉因具有管径长度匹配、无需抗排斥、低感染风险等优点可作为肝静脉重建的理想材料。

Objective To explore the short-term effect of allogeneic vascular transplantation in radical operation for primary liver cancer with hepatic vein involvement.Methods The clinical data were retrospectively analyzed of a 50 years old female primary liver cancer patient with right hepatic vein involved.AⅦandⅧsegmental hepatectomy was used combined with right hepatic vein resection and allogeneic vascular reconstruction in the First Affiliated Hospital of Hunan Normal University(Hunan People's Hospital)in July 2021.Results Ultrasound showed that the blood flow of the right hepatic vein was smooth,and there was no complication such as bile leakage,bleeding or infection after operation.The patient was treated with antiviral and targeted drugs regularly,and she is still alive tumor-free.Conclusion Radical hepatic resection combined with allogeneic vascular transplantation is confirmed to have an effective short-term result for primary liver cancer with hepatic vein involvement.Allogeneic vein can be used as an ideal material for hepatic vein reconstruction for the advantages of its suitable diameter and length,immunosuppressant-free and low risk of infection.