肝静脉剥夺术的研究进展

贺本松, 肖鸣, 张琪佳, 项灿宏, 王言雄, 李迎博, 王之烁

PDF(597 KB)
中国高校科技期刊信息汇聚平台
PDF(597 KB)
临床肝胆病杂志 ›› 2025, Vol. 41 ›› Issue (1) : 183-188. DOI: 10.12449/JCH250128
综述

肝静脉剥夺术的研究进展

作者信息 +

Research advances in liver venous deprivation

Author information +
History +

摘要

门静脉栓塞术（PVE）可引起栓塞肝叶的萎缩和非栓塞肝叶的代偿性再生。但是由于PVE术后残余肝脏（FLR）再生不充分，因此部分患者在PVE术后仍不适合行肝切除术。近年来，行PVE同时行肝静脉栓塞术（HVE）的肝静脉剥夺术（LVD）显示出诱导FLR进一步再生的效果。相比联合肝脏离断和门静脉结扎二步肝切除术，LVD触发了更快、更强的FLR再生，且术后并发症发生率和病死率更低。本文总结了LVD的相关文献，介绍LVD的有效性并分析各种技术路径的差异和安全性，认为LVD是一种安全且有效的术前预处理方法。

Abstract

Portal vein embolization （PVE） can induce atrophy of the embolized lobe and compensatory regeneration of the non-embolized lobe. However， due to inadequate regeneration of future liver remnant （FLR） after PVE， some patients remain unsuitable for hepatectomy after PVE. In recent years， liver venous deprivation （LVD）， which combines PVE with hepatic vein embolization （HVE）， has induced enhanced FLR regeneration. Compared with associating liver partition and portal vein ligation for staged hepatectomy （ALPPS）， LVD triggers faster and more robust FLR regeneration， with lower incidence rate of postoperative complications and mortality rate. By reviewing related articles on LVD， this article introduces the effectiveness of LVD and analyzes the differences and safety of various technical paths， and it is believed that LVD is a safe and effective preoperative pretreatment method.

关键词

肝静脉剥夺术 / 门静脉栓塞 / 肝静脉栓塞

Key words

Liver Venous Deprivation / Portal Vein Embolization / Hepatic Vein Embolization

引用本文

EndNote

Ris (Procite)

Bibtex

导出引用
贺本松 , 肖鸣 , 张琪佳 , 等. 肝静脉剥夺术的研究进展. 临床肝胆病杂志. 2025, 41(1): 183-188 https://doi.org/10.12449/JCH250128
Bensong HE, Ming XIAO, Qijia ZHANG, et al. Research advances in liver venous deprivation[J]. Journal of Clinical Hepatol. 2025, 41(1): 183-188 https://doi.org/10.12449/JCH250128

参考文献

列表( 原文顺序 | 文献年度倒序 | 文中引用次数倒序 ) 可视化分析
1
KISHI Y, ABDALLA EK, CHUN YS, et al. Three hundred and one consecutive extended right hepatectomies: Evaluation of outcome based on systematic liver volumetry[J]. Ann Surg, 2009, 250(4): 540-548. DOI: 10.1097/SLA.0b013e3181b674df .
本文引用 [1]
2
HEMMING AW, REED AI, HOWARD RJ, et al. Preoperative portal vein embolization for extended hepatectomy[J]. Ann Surg, 2003, 237(5): 686-691; discussion 691-693. DOI: 10.1097/01.SLA.0000065265.16728.C0 .
本文引用 [1]
3
VAUTHEY JN, CHAOUI A, DO KA, et al. Standardized measurement of the future liver remnant prior to extended liver resection: Methodology and clinical associations[J]. Surgery, 2000, 127(5): 512-519. DOI: 10.1067/msy.2000.105294 .
本文引用 [1]
4
WAKABAYASHI H, ISHIMURA K, OKANO K, et al. Application of preoperative portal vein embolization before major hepatic resection in patients with normal or abnormal liver parenchyma[J]. Surgery, 2002, 131(1): 26-33. DOI: 10.1067/msy.2002.118259 .
本文引用 [1]
5
TRUANT S, SCATTON O, DOKMAK S, et al. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): Impact of the inter-stages course on morbi-mortality and implications for management[J]. Eur J Surg Oncol, 2015, 41(5): 674-682. DOI: 10.1016/j.ejso.2015.01.004 .
本文引用 [2]
6
GUIU B, CHEVALLIER P, DENYS A, et al. Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: The liver venous deprivation technique[J]. Eur Radiol, 2016, 26(12): 4259-4267. DOI: 10.1007/s00330-016-4291-9 .
本文引用 [7]
7
GUIU B, QUENET F, ESCAL L, et al. Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function[J]. Eur Radiol, 2017, 27(8): 3343-3352. DOI: 10.1007/s00330-017-4744-9 .
本文引用 [6]
8
LE ROY B, PERREY A, FONTARENSKY M, et al. Combined preoperative portal and hepatic vein embolization (biembolization) to improve liver regeneration before major liver resection: A preliminary report[J]. World J Surg, 2017, 41(7): 1848-1856. DOI: 10.1007/s00268-017-4016-5 .
本文引用 [2]
9
KHAYAT S, CASSESE G, QUENET F, et al. Oncological outcomes after liver venous deprivation for colorectal liver metastases: A single center experience[J]. Cancers (Basel), 2021, 13(2): 200. DOI: 10.3390/cancers13020200 .
本文引用 [2]
10
HWANG S, LEE SG, KO GY, et al. Sequential preoperative ipsilateral hepatic vein embolization after portal vein embolization to induce further liver regeneration in patients with hepatobiliary malignancy[J]. Ann Surg, 2009, 249(4): 608-616. DOI: 10.1097/SLA.0b013e31819ecc5c .
本文引用 [4]
11
MUNENE G, PARKER RD, LARRIGAN J, et al. Sequential preoperative hepatic vein embolization after portal vein embolization for extended left hepatectomy in colorectal liver metastases[J]. World J Surg Oncol, 2013, 11: 134. DOI: 10.1186/1477-7819-11-134 .
本文引用 [1]
12
HWANG S, HA TY, KO GY, et al. Preoperative sequential portal and hepatic vein embolization in patients with hepatobiliary malignancy[J]. World J Surg, 2015, 39(12): 2990-2998. DOI: 10.1007/s00268-015-3194-2 .
本文引用 [6]
13
NIEKAMP AS, HUANG SY, MAHVASH A, et al. Hepatic vein embolization after portal vein embolization to induce additional liver hypertrophy in patients with metastatic colorectal carcinoma[J]. Eur Radiol, 2020, 30(7): 3862-3868. DOI: 10.1007/s00330-020-06746-4 .
本文引用 [1]
14
ARAKI K, SHIBUYA K, HARIMOTO N, et al. A prospective study of sequential hepatic vein embolization after portal vein embolization in patients scheduled for right-sided major hepatectomy: Results of feasibility and surgical strategy using functional liver assessment[J]. J Hepatobiliary Pancreat Sci, 2023, 30(1): 91-101. DOI: 10.1002/jhbp.1207 .
本文引用 [3]
15
LAURENT C, FERNANDEZ B, MARICHEZ A, et al. Radiological simultaneous portohepatic vein embolization (RASPE) before major hepatectomy: A better way to optimize liver hypertrophy compared to portal vein embolization[J]. Ann Surg, 2020, 272(2): 199-205. DOI: 10.1097/SLA.0000000000003905 .
本文引用 [3]
16
LEE SS, KIM KW, PARK SH, et al. Value of CT and Doppler sonography in the evaluation of hepatic vein stenosis after dual-graft living donor liver transplantation[J]. AJR Am J Roentgenol, 2007, 189(1): 101-108. DOI: 10.2214/AJR.06.1366 .
本文引用 [1]
17
HWANG S. Right hepatectomy in a patient with hepatocellular carcinoma after induction of hepatic parenchymal atrophy through subsequent portal and hepatic vein embolizations[J]. Korean J Gastroenterol, 2011, 58(3): 162-165. DOI: 10.4166/kjg.2011.58.3.162 .
本文引用 [1]
18
NAKAMURA S, TSUZUKI T. Surgical anatomy of the hepatic veins and the inferior vena cava[J]. Surg Gynecol Obstet, 1981, 152(1): 43-50.
本文引用 [1]
19
SANO K, MAKUUCHI M, MIKI K, et al. Evaluation of hepatic venous congestion: Proposed indication criteria for hepatic vein reconstruction[J]. Ann Surg, 2002, 236(2): 241-247. DOI: 10.1097/00000658-200208000-00013 .
20
AKAMATSU N, SUGAWARA Y, KANEKO J, et al. Effects of middle hepatic vein reconstruction on right liver graft regeneration[J]. Transplantation, 2003, 76(5): 832-837. DOI: 10.1097/01.TP.0000085080.37235.81 .
本文引用 [1]
21
HOCQUELET A, SOTIRIADIS C, DURAN R, et al. Preoperative portal vein embolization alone with biliary drainage compared to a combination of simultaneous portal vein, right hepatic vein embolization and biliary drainage in klatskin tumor[J]. Cardiovasc Intervent Radiol, 2018, 41(12): 1885-1891. DOI: 10.1007/s00270-018-2075-0 .
本文引用 [2]
22
PANARO F, GIANNONE F, RIVIERE B, et al. Perioperative impact of liver venous deprivation compared with portal venous embolization in patients undergoing right hepatectomy: Preliminary results from the pioneer center[J]. Hepatobiliary Surg Nutr, 2019, 8(4): 329-337. DOI: 10.21037/hbsn.2019.07.06 .
本文引用 [2]
23
BÖNING G, FEHRENBACH U, AUER TA, et al. Liver venous deprivation (LVD) versus portal vein embolization (PVE) alone prior to extended hepatectomy: A matched pair analysis[J]. Cardiovasc Intervent Radiol, 2022, 45(7): 950-957. DOI: 10.1007/s00270-022-03107-0 .
本文引用 [4]
24
GUIU B, QUENET F, PANARO F, et al. Liver venous deprivation versus portal vein embolization before major hepatectomy: Future liver remnant volumetric and functional changes[J]. Hepatobiliary Surg Nutr, 2020, 9(5): 564-576. DOI: 10.21037/hbsn.2020.02.06 .
本文引用 [3]
25
HARUKI K, FURUKAWA K, ASHIDA H, et al. Simultaneous dual hepatic vascular embolization (DHVE) for massive hepatectomy[J]. Ann Surg Oncol, 2021, 28(13): 8246. DOI: 10.1245/s10434-021-10433-z .
本文引用 [1]
26
MASTHOFF M, KATOU S, KÖHLER M, et al. Portal and hepatic vein embolization prior to major hepatectomy[J]. Z Gastroenterol, 2021, 59(1): 35-42. DOI: 10.1055/a-1330-9450 .
本文引用 [4]
27
DELLA CORTE A, SANTANGELO D, AUGELLO L, et al. Single-center retrospective study comparing double vein embolization via a trans-jugular approach with liver venous deprivation via a trans-hepatic approach[J]. Cardiovasc Intervent Radiol, 2023, 46(12): 1703-1712. DOI: 10.1007/s00270-023-03538-3 .
本文引用 [1]
28
DONDORF F, DEEB AA, BAUSCHKE A, et al. Ligation of the middle hepatic vein to increase hypertrophy induction during the ALPPS procedure[J]. Langenbecks Arch Surg, 2021, 406(4): 1111-1118. DOI: 10.1007/s00423-021-02181-1 .
本文引用 [1]
29
DELLA CORTE A, FIORENTINI G, RATTI F, et al. Combining laparoscopic liver partitioning and simultaneous portohepatic venous deprivation for rapid liver hypertrophy[J]. J Vasc Interv Radiol, 2022, 33(5): 525-529. DOI: 10.1016/j.jvir.2022.01.018 .
本文引用 [1]
30
LIAO YB, YUAN CX, ZHANG N, et al. Laparoscopic hepatic vein deprivation[J]. Chin J Bases Clin Gen Surg, 2022, 29(12): 1568-1572. DOI: 10.7507/1007-9424.202206019 .
廖玉波, 袁承祥, 张娜, 等. 腹腔镜下肝静脉剥夺术[J]. 中国普外基础与临床杂志, 2022, 29(12): 1568-1572. DOI: 10.7507/1007-9424.202206019 .
本文引用 [1]
31
NAJAFI A, SCHADDE E, BINKERT CA. Combined simultaneous embolization of the portal vein and hepatic vein (double vein embolization)-a technical note about embolization sequence[J]. CVIR Endovasc, 2021, 4(1): 43. DOI: 10.1186/s42155-021-00230-w .
本文引用 [1]
32
SY TV, DUNG LT, GIANG BV, et al. Safety and efficacy of liver venous deprivation following transarterial chemoembolization before major hepatectomy for hepatocellular carcinoma[J]. Ther Clin Risk Manag, 2023, 19: 425-433. DOI: 10.2147/TCRM.S411080 .
本文引用 [1]
33
SCHADDE E, ARDILES V, SLANKAMENAC K, et al. ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors compared with conventional-staged hepatectomies: Results of a multicenter analysis[J]. World J Surg, 2014, 38(6): 1510-1519. DOI: 10.1007/s00268-014-2513-3 .
本文引用 [2]
34
CROOME KP, HERNANDEZ-ALEJANDRO R, PARKER M, et al. Is the liver kinetic growth rate in ALPPS unprecedented when compared with PVE and living donor liver transplant? A multicentre analysis[J]. HPB (Oxford), 2015, 17(6): 477-484. DOI: 10.1111/hpb.12386 .
本文引用 [1]
35
HEIL J, KORENBLIK R, HEID F, et al. Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis[J]. Br J Surg, 2021, 108(7): 834-842. DOI: 10.1093/bjs/znaa149 .
本文引用 [5]
36
MARINO R, RATTI F, DELLA CORTE A, et al. Comparing liver venous deprivation and portal vein embolization for perihilar cholangiocarcinoma: Is it time to shift the focus to hepatic functional reserve rather than hypertrophy?[J]. Cancers (Basel), 2023, 15(17): 4363. DOI: 10.3390/cancers15174363 .
本文引用 [1]
37
GAVRIILIDIS P, MARANGONI G, AHMAD J, et al. Simultaneous portal and hepatic vein embolization is better than portal embolization or ALPPS for hypertrophy of future liver remnant before major hepatectomy: A systematic review and network meta-analysis[J]. Hepatobiliary Pancreat Dis Int, 2023, 22(3): 221-227. DOI: 10.1016/j.hbpd.2022.08.013 .
本文引用 [1]
38
CASSESE G, TROISI RI, KHAYAT S, et al. Liver venous deprivation versus associating liver partition and portal vein ligation for staged hepatectomy for colo-rectal liver metastases: A comparison of early and late kinetic growth rates, and perioperative and oncological outcomes[J]. Surg Oncol, 2022, 43: 101812. DOI: 10.1016/j.suronc.2022.101812 .
本文引用 [1]
39
KOBAYASHI K, YAMAGUCHI T, DENYS A, et al. Liver venous deprivation compared to portal vein embolization to induce hypertrophy of the future liver remnant before major hepatectomy: A single center experience[J]. Surgery, 2020, 167(6): 917-923. DOI: 10.1016/j.surg.2019.12.006 .
本文引用 [4]
40
de GRAAF W, van LIENDEN KP, van den ESSCHERT JW, et al. Increase in future remnant liver function after preoperative portal vein embolization[J]. Br J Surg, 2011, 98(6): 825-834. DOI: 10.1002/bjs.7456 .
本文引用 [2]
41
de GRAAF W, BENNINK RJ, VETELÄINEN R, et al. Nuclear imaging techniques for the assessment of hepatic function in liver surgery and transplantation[J]. J Nucl Med, 2010, 51(5): 742-752. DOI: 10.2967/jnumed.109.069435 .
本文引用 [1]
42
KWON AH, MATSUI Y, KAIBORI M, et al. Functional hepatic regeneration following hepatectomy using galactosyl-human serum albumin liver scintigraphy[J]. Transplant Proc, 2004, 36(8): 2257-2260. DOI: 10.1016/j.transproceed.2004.08.075 .
本文引用 [1]
43
TRUANT S, BAILLET C, DESHORGUE AC, et al. Drop of total liver function in the interstages of the new associating liver partition and portal vein ligation for staged hepatectomy technique: Analysis of the “auxiliary liver” by HIDA scintigraphy[J]. Ann Surg, 2016, 263(3): e33-e34. DOI: 10.1097/SLA.0000000000001603 .
本文引用 [1]
44
OLDHAFER F, RINGE KI, TIMROTT K, et al. Monitoring of liver function in a 73-year old patient undergoing ‘Associating Liver Partition and Portal vein ligation for Staged hepatectomy’: Case report applying the novel liver maximum function capacity test[J]. Patient Saf Surg, 2016, 10: 16. DOI: 10.1186/s13037-016-0104-y .
45
TRUANT S, BAILLET C, DESHORGUE AC, et al. Hepatobiliary scintigraphy in ALPPS: A response[J]. Ann Surg, 2017, 266(6): e112-e113. DOI: 10.1097/SLA.0000000000001941 .
本文引用 [1]
46
LIU C, ZHANG XY, JIN C, et al. Application of liver venous deprivation before two-stage radical hepatectomy in liver cancer patients[J]. Chin J Bases Clin Gen Surg, 2019, 26(7): 841-846. DOI: 10.7507/1007-9424.201906029 .
刘畅, 张晓赟, 金谌, 等. 肝静脉系统栓堵术在第二阶段根治性肝癌切除术中的应用[J]. 中国普外基础与临床杂志, 2019, 26(7): 841-846. DOI: 10.7507/1007-9424.201906029 .
本文引用 [1]
47
YAMASHITA S, SAKAMOTO Y, YAMAMOTO S, et al. Efficacy of preoperative portal vein embolization among patients with hepatocellular carcinoma, biliary tract cancer, and colorectal liver metastases: A comparative study based on single-center experience of 319 cases[J]. Ann Surg Oncol, 2017, 24(6): 1557-1568. DOI: 10.1245/s10434-017-5800-z .
本文引用 [1]
48
LE ROY B, GALLON A, CAUCHY F, et al. Combined biembolization induces higher hypertrophy than portal vein embolization before major liver resection[J]. HPB (Oxford), 2020, 22(2): 298-305. DOI: 10.1016/j.hpb.2019.08.005 .
本文引用 [1]
49
GOROSPE L, COBOS-ALONSO J, URBANO-GARCÍA J. Cyanoacrylate pulmonary embolism following combined portal and hepatic vein embolization[J]. Arch Bronconeumol, 2023, 59(4): 263. DOI: 10.1016/j.arbres.2023.02.015 .
本文引用 [2]
50
NAGINO M, YAMADA T, KAMIYA J, et al. Left hepatic trisegmentectomy with right hepatic vein resection after right hepatic vein embolization[J]. Surgery, 2003, 133(5): 580-582. DOI: 10.1067/msy.2003.105 .
本文引用 [1]
51
LE TD, THAN VS, NGUYEN MD, et al. Mortality following transarterial embolization due to hemorrhage after liver venous deprivation[J]. Int J Gastrointest Interv, 2022, 11(2): 85-88. DOI: 10.18528/ijgii210034 .
本文引用 [1]
52
CHEBARO A, BUC E, DURIN T, et al. Liver venous deprivation or associating liver partition and portal vein ligation for staged hepatectomy?: A retrospective multicentric study[J]. Ann Surg, 2021, 274(5): 874-880. DOI: 10.1097/SLA.0000000000005121 .
本文引用 [3]
53
KORENBLIK R, JFJA van ZON, OLIJ B, et al. Resectability of bilobar liver tumours after simultaneous portal and hepatic vein embolization versus portal vein embolization alone: Meta-analysis[J]. BJS Open, 2022, 6(6): zrac141. DOI: 10.1093/bjsopen/zrac141 .
本文引用 [2]
54
CHAOUCH MA, MAZZOTTA A, da COSTA AC, et al. A systematic review and meta-analysis of liver venous deprivation versus portal vein embolization before hepatectomy: Future liver volume, postoperative outcomes, and oncological safety[J]. Front Med (Lausanne), 2023, 10: 1334661. DOI: 10.3389/fmed.2023.1334661 .
本文引用 [2]
55
COUTO M, GIANONNE F, GUIU B, et al. Surgical strategy for future remnant liver hypertrophy: Portal vein embolization vs. liver venous deprivation[J]. HPB, 2021, 23: S46-S47. DOI: 10.1016/j.hpb.2020.11.111 .
本文引用 [1]
56
CASSESE G, TROISI RI, KHAYAT S, et al. Liver venous deprivation versus portal vein embolization before major hepatectomy for colorectal liver metastases: A retrospective comparison of short- and medium-term outcomes[J]. J Gastrointest Surg, 2023, 27(2): 296-305. DOI: 10.1007/s11605-022-05551-2 .
本文引用 [1]
57
ZHANG L, YANG ZT, ZHANG SY, et al. Conventional two-stage hepatectomy or associating liver partitioning and portal vein ligation for staged hepatectomy for colorectal liver metastases? A systematic review and meta-analysis[J]. Front Oncol, 2020, 10: 1391. DOI: 10.3389/fonc.2020.01391 .
本文引用 [1]
58
KORENBLIK R, OLIJ B, ALDRIGHETTI LA, et al. Dragon 1 protocol manuscript: Training, accreditation, implementation and safety evaluation of portal and hepatic vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy[J]. Cardiovasc Intervent Radiol, 2022, 45(9): 1391-1398. DOI: 10.1007/s00270-022-03176-1 .
本文引用 [1]

作者贡献声明

贺本松负责文献检索，资料分析，撰写及修改论文；肖鸣、张琪佳负责收集数据，文献检索和整理；王言雄、李迎博、王之烁参与修改；项灿宏负责拟定写作思路，确定框架，指导撰写文章并最后定稿。

评论

PDF(597 KB)

Accesses

Citation

Detail
段落导航
相关文章
Copyright 中国高校科技期刊信息汇聚平台 2024-2025
技术支持：北京玛格泰克科技发展有限公司
京ICP备05021913号-19

/

〈 〉