Association Between Intrahepatic Portoportal Venous Collateral Vascular Formation and Postoperative Liver Hyperplasia in Patients with Liver Partition and Portal Vein Ligation
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2022.0612
- VernacularTitle:肝脏分隔及门静脉右支结扎术后肝内门静脉侧支血管开放与肝组织增生关联分析
- Author:
Ze-bin CHEN
1
;
Mi-mi TANG
2
;
Shi-ting FENG
2
;
Shun-li SHEN
1
;
Ming KUANG
1
Author Information
1. Center of Hepato-Pancreato-Biliary Surgery， The First Affiliated Hospital， Sun Yat-sen University， Guangzhou 510080， China
2. Department of Diagnostic Radiology， The First Affiliated Hospital， Sun Yat-sen University， Guangzhou 510080， China
- Publication Type:Journal Article
- Keywords:
intrahepatic portoportal venous collateral vascular;
liver partition and portal vein ligation;
future liver remnant hypertrophy;
hepatocellular carcinoma
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2022;43(6):967-975
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the association between intrahepatic portoportal venous collateral vascular formation and postoperative liver hyperplasia in patients undergoing liver partition and portal vein ligation. MethodsThe clinical data of patients with hepatocellular carcinoma who underwent liver partition and portal vein ligation at the Center of Hepato-Pancreatico-Biliary Surgery in the First Affiliated Hospital of Sun Yat-sen University from April 2013 to June 2022 were retrospectively analyzed. All the patients were grouped according to the number of open collateral vessels in the liver after first-stage surgery， including the group with no formation of intrahepatic portoportal venous collateral vessel （IPCs=0）， the group with 1 formation of intrahepatic portoportal venous collateral vessel （IPCs=1）， and the group with more than 2 formations of intrahepatic portoportal venous collateral vessels （IPCs ≥ 2）. The differences in the distribution of the three groups in terms of preoperative， intraoperative and postoperative liver function， formation of intrahepatic portoportal venous collateral vessels on both sides， and second-stage surgery were analyzed firstly， and then multiple linear regression analysis was used to explore the factors affecting the number of IPCs. ResultsOf all the 37 patients with hepatocellular carcinoma who were finally included in this study， there were no significant differences in preoperative data between the three groups （P>0.05）. The surgical procedure was different between the three groups. The proportion of patients with ≥ 2 open vessels who underwent laparoscopic microwave ablation liver partition was greater than that of patients with split liver （57.14% vs. 42.56%，P=0.031）. There was a statistically significant difference in the daily hypertrophy volume of future liver remnant （FLR） ［IPCs ≥ 2 vs. IPCs=1 vs. IPCs=0，（14.25±8.81 vs. 20.65±9.85 vs. 30.10±19.31） mL，P=0.018］. There was no difference in the proportion of patients between the three groups who underwent second-stage resection （P=0.363）. However， the number of days between surgeries was significantly longer in those with ≥2 open collateral vessels than in those with no opening or only 1 opening （16.31±5.44 vs. 10.30±3.40 vs. 12.78±3.35） days，P=0.023. Multiple linear regression analysis found that the surgical procedure was the only factor affecting the number of intrahepatic collateral vessel openings （P=0.031）. The number of IPCs after laparoscopic microwave ablation liver partition and split liver was ［2.0 （1.5） vs. 1.0 （1.0），P=0.031］. ConclusionsThe number of IPCs after liver partition and portal vein right branch ligation is negatively associated with the hypertrophy rate of FLR and split of liver is recommended to reduce the formation of IPCs.
