摘要
肝切除术后剩余肝脏(FLR)体积不足常导致肝衰竭等并发症,甚至死亡,是肝脏外科亟需解决的瓶颈问题之一。联合肝脏离断和门静脉结扎的二步肝切除术(ALPPS)是近年兴起的二步肝切除术,能够促进FLR迅速再生,但其机制尚未阐述清楚。回顾了国内外近年的研究进展,综述了ALPPS促进肝脏再生的血流动力学因素和体液因素、ALPPS对肝实质细胞的影响以及肝星状细胞、自然杀伤细胞、巨噬细胞、肝干/祖细胞等肝非实质细胞对肝脏再生的调节作用。指出肝非实质细胞与实质细胞间相互作用将是ALPPS术后肝再生机制研究的热点视角。
Insufficient volume of future liver remnant(FLR)often leads to the complications including liver failure and even death and thus remains a bottleneck for liver surgery.Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)is a newly developed two-stage hepatectomy procedure which can promote rapid regeneration of FLR,but the related mechanism has not yet been elucidated.With reference to the recent research advances in China and foreign countries,this article reviews the hemodynamic and humoral factors for ALPPS in promoting liver regeneration,the effect of ALPPS on liver parenchymal cells,and the role of non-parenchymal liver cells(including hepatic stellate cells,natural killer cells,macrophages,and liver progenitor/stem cells)in regulating liver regeneration.It is pointed out that the interaction between non-parenchymal liver cells and parenchymal cells is a hotspot in the research on the mechanism of liver regeneration after ALPPS.
作者
曾陶飞
陈光磊
刘彩刚
戴朝六
徐锋
ZENG Taofei;CHEN Guanglei;LIU Caigang;DAI Chaoliu;XU Feng(Department of General Surgery,Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2020年第10期2344-2348,共5页
Journal of Clinical Hepatology
基金
辽宁省自然科学基金项目(20180551193,2020-MS-181)
盛京医院345人才工程计划资助(40B)。
关键词
肝切除术
肝再生
肝功能衰竭
hepatectomy
liver regeneration
liver failure
