Strategies to increase the resectability of hepatocellular carcinoma

Hepatocellular carcinoma(HCC) is best treated by liver transplantation, but the applicability of transplantation is greatly limited. Tumor resection in partial hepatectomy is hence resorted to. However, in most parts of the world, only 20%-30% of HCCs are resectable. The main reason for such a low resectability is a future liver remnant too small to be sufficient for the patient. To allow more HCC patients to undergo curative hepatectomy, a variety of ways have been developed to increase the resectability of HCC, mainly ways to increase the future liver remnants in patients through hypertrophy. They include portal vein embolization, sequential transarterial chemoembolization and portal vein embolization, staged hepatectomy, two-staged hepatectomy with portal vein ligation, and Associating Liver Partition and Portal Vein Ligation in Staged Hepatectomy. Herein we review, describe and evaluate these different ways, ways that can be life-saving.

时相法心/肝比值在肝硬化诊断中的临床应用

目的 通过时相法心 /肝比值的测定 ,对肝硬化导致的肝门脉高压、门静脉分流以及肝脾功能进行综合判断 ;方法 放射性心肌灌注显像剂99mTc MIBI经直肠给药 ,通过门脉分流回流入体循环 ,使不应显像的心肌显像 ;通过计算心 /肝 (H/L)比值 ,对肝硬化程度进行判断。结果 正常组与肝炎、肝硬化组时相分时相心 /肝比值有显著性差异 (t=2 2 14,P <0 0 5) ;肝硬化组早期与肝炎组H/L比值无意义外 ,其余各组分时相均有显著性差异 (t=3 0 0 3,P <0 0 0 1)。结论 时相法心 /肝比值对肝炎、肝硬化所造成的肝功能减低、门静脉分流和门静脉回流的诊断有显著的意义 ,是一项比较灵敏而特异的指标。