Recently, Zhang Yu and Yang Chong's surgical team of the Sichuan Provincial People's Hospital Organ Transplantation Center used ALPPS (phased hepatectomy combined with hepatic segmentation and portal vein ligation) in combination with hemi-extraction hepatectomy and autologous liver transplantation to successfully treat a case of advanced liver. Hydatid patients.
Hepatic alveolar echinococcosis is known as "insect cancer," because of its high mortality. The 38-year-old female patient, from Aba County, Sichuan Province, suffered from hepatoic echinococcosis for many years. The liver was eroded by several large hydatid lesions, and only the sixth segment of the liver (VI) had a normal inflow. Road, outflow structure. The lesions severely eroded the posterior inferior vena cava and the second hepatic portal vein and lost normal surgical resection indications. The patients who had visited the hospital were considered unable to undergo radical resection.
In November 2017, the patient went to the Sichuan Provincial People's Hospital for treatment. Due to the patient's residual liver (VI) volume was not enough, after a multi-disciplinary discussion, it was decided to use the first phase of ALPPS surgery to stimulate VI segmental hepatic hyperplasia, after the residual hepatic hyperplasia was sufficient. , And then use the autologous liver transplantation technology for the treatment of two radical resection.
In May of this year, after the first phase of ALPPS surgery, the surviving healthy segment of the VI segment survived six months of growth, and its volume increased to a “safe line†to meet the patient's residual liver volume after hepatectomy. After full preoperative preparation, recently, patients have undergone phase II autologous liver transplantation, and all liver hydatid lesions have been radically removed. At present, patients recover well and all indicators are near normal.
ALPPS technology and autologous liver transplantation technology are extremely difficult techniques for hepatobiliary surgery. The organ transplant center of the hospital jointly used two techniques of ultra-high difficulty in liver surgery to find a new approach for surgical treatment of the traditionally unresectable advanced hepatoic echinococcosis. (Correspondent Zhang Li Liu Xinyue Special Reporter Yang Limei)
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