门静脉动脉化在肝门胆管癌根治术中的应用研究进展_West China Medical Journal

Authors：

雷建勇 ¹ , 钟金晶 ² ,  王文涛 ¹ , 严律南 ¹

Corresponding author：

王文涛, Email: leijianyong11@163.com

Keywords：

门静脉动脉化; 肝门部胆管癌; 应用

Video：

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将肝动脉内的血流引入到门静脉系统内，即门静脉动脉化技术，已经在肝门部胆管癌根治术中得到广泛应用，但其应用仍存在争议。现复习近年来国内、外有关门静脉动脉化在治疗肝门部胆管癌的文献并进行综述，从而探讨门静脉动脉化在肝门部胆管癌根治术中使用的利弊，以更好地指导临床工作。

Citation： 雷建勇,钟金晶,王文涛,严律南. 门静脉动脉化在肝门胆管癌根治术中的应用研究进展. West China Medical Journal, 2012, 27(10): 1561-1565. doi: Copy

1.	梁廷波, 汤晓锋. 肝门部胆管癌的诊治现状[J]. 肝胆外科杂志, 2010, 18(5): 327-331.
2.	孙诚谊, 汪建新. 肝门部胆管癌的外科治疗[J]. 世界华人消化杂志, 2011, 19(8): 771-776.
3.	汤地, 梁力建, 黄洁夫. 肝门部胆管癌86例的诊断与治疗[J]. 中华普通外科杂志, 2001, 16(9): 517-519.
4.	孙备, 王拥卫, 姜洪池. 肝门部胆管癌的外科治疗进展[J]. 中华消化外科杂志, 2010, 9(3): 237-240.
5.	Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation[J]. Am J Surg, 1966, 112(3): 337-347.
6.	Ito F, Cho CS, Rikkers LF, et al. Hilar cholangiocarcinoma: current management[J]. Ann Surg, 2009, 250(2): 210-218.
7.	Gaudio E, Franchitto A, Pannarale L, et al. Cholangiocytes and blood supply[J]. World J Gastroenterol, 2006, 12(22): 3546-3552.
8.	Beaussier M, Wendum D, Fouassier L, et al. Adaptative bile duct proliferative response in experimental bile duct ischemia[J]. J Hepatol, 2005, 42(2): 257-265.
9.	周宁新, 黄志强, 冯玉泉, 等. 肝门部胆管癌根治性切除手术方式的改进[J]. 中华普通外科杂志, 2001, 16(2): 82-84.
10.	Gerhards MF, van Gulik TM, de Wit LT, et al. Evaluation of morbidity and mortality after resection for hilar cholangiocarcinoma: a single center experience[J]. Surgery, 2000, 127(4): 395-404.
11.	Kondo S, Hirano S, Ambo Y, et al. Arterioportal shunting as an alternative to microvascular reconstruction after hepatic artery resection[J]. Br J Surg, 2004, 91(2): 248-251.
12.	Zhang JJ, Niu JX, Dong CX, et al. Portal vein arterialization used in partial hepatectomy maintains liver regeneration[J]. Sci Res Essay, 2011, 6(30): 6325-6330.
13.	陈东, 赖伟明, 梁力建, 等. 肝门部胆管癌切除术中的血管切除重建[J]. 中华外科杂志, 2011, 49(7): 607-610.
14.	Qiu J, Wu H, Prasoon P, et al. Portal vein arterialization in hilar cholangiocarcinoma: one case report and literature review[J]. Eur J Gastroenterol Hepatol, 2012, 24(3): 229-232.
15.	Young AL, Prasad KR, Adair R, et al. Portal vein arterialization as a salvage procedure during left hepatic trisectionectomy for hilar cholangiocarcinoma[J]. J Am Coll Surg, 2008, 207(5): e1-e6.
16.	陈永亮, 黄志强, 周宁新, 等. 门静脉动脉化在肝门部胆管癌根治性切除术中的应用[J]. 中华普通外科杂志, 2007, 22(6): 404-406.
17.	Narath A. Über die Entstehung der anämischen Lebernekrose nach Unterbindung der Arteria hepatica undihre Verhütung durch arterio-portale Anastomose[J]. Dtsch Z Chir , 1996, 135(4-5): 305–378.
18.	李坚, 刘琦, 关晓东, 等. 利用右肾动脉行入肝门静脉动脉化加门腔分流术的试验研究[J]. 中华普通外科杂志, 2010, 25(3): 227-230.
19.	Shimizu Y, Miyazaki M, Shimizu H, et al. Beneficial effects of arterialization of the portal vein on extended hepatectomy[J]. Br J Surg, 2000, 87(6): 784-789.
20.	Tsivian M, Neri F, Prezzi D, et al. Portal vein arterialization in hepatobiliary surgery and liver transplantation[J]. Transplant Proc, 2007, 39(6): 1877-1878.
21.	王鹏, 李鹏, 芮理, 等. 门静脉动脉化对肝硬化犬肝切除后肝再生的作用[J]. 世界华人消化杂志, 2009, 17(24): 2499-2502.
22.	李坚, 关晓东, 刘琦, 等. 入肝门静脉动脉化加门腔分流对大鼠肝脏再生的影响[J]. 中山大学学报, 2010, 31(4): 508-512.
23.	Zhang JJ, Meng XK. Current status and perspectives of application of portal vein arterialization in hepatobiliary surgery[J]. Chin J Hepatob Surg, 17(4): 349-352.
24.	Guo SH, Li CH, Chen YL, et al. Effects of partial portal vein arterialization on the hilar bile duct in a rat model[J]. Hepatobiliary Pancreat Dis Int, 2011, 10(5): 533-538.
25.	吴葆莹, 吴崇旭, 薛承锐, 等. 门静脉动脉化对梗阻性黄疸的临床应用[J]. 江苏医药, 2010, 36(12): 1465-1466.
26.	Jang JS, Park DJ. Actual long-term outcome of extrahepatic bile duct Cancer after surgical resection[J]. Ann Surg, 2005, 241(1):77-84.
27.	Parikh AA. Abdalla EK, Vauthey JN. Operative considerations in resection of hilar cholangiocarcinoma[J]. HPB, 2005, 7(4): 254-258.
28.	沈世强, 张训臣. 肝切除时门静脉血部分动脉化的研究[J]. 中华实验外科杂志, 2000, 17(3): 235-236.
29.	郭少华, 陈永亮, 李崇辉, 等. 部分门静脉动脉化后肝门部胆管细胞增生的试验研究[J]. 解放军医学杂志, 2010, 35(10): 1212-1214.
30.	陈嘉伟, 唐启彬, 王捷. 门静脉动脉化对肝脏及胆管周围血管丛的影响[J]. 岭南现代临床外科, 2009, 9(5): 351-352,356.
31.	陈永亮, 黄志强, 赵建更, 等. 部分门静脉动脉化重建肝血流的实验研究[J]. 中华普通外科杂志, 2002, 17(5): 289-290.
32.	Schleimer K, Stippel DL, Kasper HU, et al. Portal vein arterialization increases hepatocellular apoptosis and inhibits liver regeneration[J]. J Surg Res, 2008, 149(2): 250-258.
33.	李文岗, 黄志强, 高丽杰, 等. 门静脉动脉化后大鼠门静脉血液动力学改变对肝脏功能的远期影响[J]. 吉林大学学报·医学版, 2005, 31(2): 213-216.
34.	Lnoue T, Sawa T, Okada S, et al. Partial portal arterialization in complete en bloc resection of the hepatoduodenal ligament and left lobe of the liver for hepatic hilar Cancer[J]. Hepatogastroenterology, 2000, 47(32): 533-536.
35.	陈永亮, 黄志强, 王迎宾. 门静脉动脉化对实验性梗阻性黄疸大鼠肝细胞凋亡的影响[J]. 中华普通外科杂志, 2000, 15(6): 348-351.
36.	陈永亮, 黄晓强, 黄志强, 等. 限制流量的部分门静脉动脉化重建肝血流的实验研究[J]. 解放军医学杂志, 2007, 32(3): 218-220.
37.	陈永亮, 黄晓强, 黄志强, 等. 限制流量部分门静脉动脉化的临床应用研究[J]. 医学研究杂志, 2011, 40(9): 35-37.
38.	陈永亮, 黄晓强, 黄志强, 等. 限制流量部分门静脉动脉化重建肝血流的临床观察[J]. 中华普通外科杂志, 2011, 26(3): 259.
39.	李文岗, 李滨, 高丽杰, 等. 限制流量门静脉动脉化对大鼠肝脏功能和结构的远期影响[J]. 中华普通外科杂志, 2006, 21(1): 55-58.
40.	Li WG, Chen YL, Chen JX, et al. Portal venous arterialization resulting in increased portal inflow and portal vein wall thickness in rats[J]. World J Gastroenterol, 2008, 14(43): 6681-6688.
41.	Pastor CM. Hepatic and splanchnic oxygen consumption during acute hypoxemic hypoxia in anesthetized pigs[J]. Crit Care Med, 2000, 28(3): 765-773.
42.	Maggi U, Camagni S, Reggiani P, et al. Portal vein arterialization for hepatic artery thrombosis in liver transplantation: a case report, Doppler-ultrasound aspects, and review of the literature[J]. Transplant Proc, 2010, 42(4): 1369-1374.
43.	Housari G, Nuño J, Calero P, et al. Portal vein arterialization in liver transplantation: an option to restore arterial flow: a case report[J]. Transplant Proc, 2011, 43(3): 755-757.
44.	Bonnet S, Sauvanet A, Bruno O, et al. Long-term survival after portal vein arterialization for portal vein thrombosis in orthotopic liver transplantation[J]. Gastroentérologie clinique et biologique, 2010, 34(1): 23-28.
45.	Li Destri G, La Greca G, Greco L, et al. Arterialization of the portal stump by right renal artery after portocaval shunt in the rat[J]. Microsurgery, 2004, 24(1): 77-80.
46.	Chen YL, Li WG, Huang ZQ, et al. Effects of portal venous arterialization on acute occlusion of hepatic artery in rats[J]. Chin Med J (Engl), 2008, 121(14): 1302-1306.

1. 　梁廷波, 汤晓锋. 肝门部胆管癌的诊治现状[J]. 肝胆外科杂志, 2010, 18(5): 327-331.
2. 　孙诚谊, 汪建新. 肝门部胆管癌的外科治疗[J]. 世界华人消化杂志, 2011, 19(8): 771-776.
3. 　汤地, 梁力建, 黄洁夫. 肝门部胆管癌86例的诊断与治疗[J]. 中华普通外科杂志, 2001, 16(9): 517-519.
4. 　孙备, 王拥卫, 姜洪池. 肝门部胆管癌的外科治疗进展[J]. 中华消化外科杂志, 2010, 9(3): 237-240.
5. 　Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation[J]. Am J Surg, 1966, 112(3): 337-347.
6. 　Ito F, Cho CS, Rikkers LF, et al. Hilar cholangiocarcinoma: current management[J]. Ann Surg, 2009, 250(2): 210-218.
7. 　Gaudio E, Franchitto A, Pannarale L, et al. Cholangiocytes and blood supply[J]. World J Gastroenterol, 2006, 12(22): 3546-3552.
8. 　Beaussier M, Wendum D, Fouassier L, et al. Adaptative bile duct proliferative response in experimental bile duct ischemia[J]. J Hepatol, 2005, 42(2): 257-265.
9. 　周宁新, 黄志强, 冯玉泉, 等. 肝门部胆管癌根治性切除手术方式的改进[J]. 中华普通外科杂志, 2001, 16(2): 82-84.
10. 　Gerhards MF, van Gulik TM, de Wit LT, et al. Evaluation of morbidity and mortality after resection for hilar cholangiocarcinoma: a single center experience[J]. Surgery, 2000, 127(4): 395-404.
11. 　Kondo S, Hirano S, Ambo Y, et al. Arterioportal shunting as an alternative to microvascular reconstruction after hepatic artery resection[J]. Br J Surg, 2004, 91(2): 248-251.
12. 　Zhang JJ, Niu JX, Dong CX, et al. Portal vein arterialization used in partial hepatectomy maintains liver regeneration[J]. Sci Res Essay, 2011, 6(30): 6325-6330.
13. 　陈东, 赖伟明, 梁力建, 等. 肝门部胆管癌切除术中的血管切除重建[J]. 中华外科杂志, 2011, 49(7): 607-610.
14. 　Qiu J, Wu H, Prasoon P, et al. Portal vein arterialization in hilar cholangiocarcinoma: one case report and literature review[J]. Eur J Gastroenterol Hepatol, 2012, 24(3): 229-232.
15. 　Young AL, Prasad KR, Adair R, et al. Portal vein arterialization as a salvage procedure during left hepatic trisectionectomy for hilar cholangiocarcinoma[J]. J Am Coll Surg, 2008, 207(5): e1-e6.
16. 　陈永亮, 黄志强, 周宁新, 等. 门静脉动脉化在肝门部胆管癌根治性切除术中的应用[J]. 中华普通外科杂志, 2007, 22(6): 404-406.
17. 　Narath A. Über die Entstehung der anämischen Lebernekrose nach Unterbindung der Arteria hepatica undihre Verhütung durch arterio-portale Anastomose[J]. Dtsch Z Chir , 1996, 135(4-5): 305–378.
18. 　李坚, 刘琦, 关晓东, 等. 利用右肾动脉行入肝门静脉动脉化加门腔分流术的试验研究[J]. 中华普通外科杂志, 2010, 25(3): 227-230.
19. 　Shimizu Y, Miyazaki M, Shimizu H, et al. Beneficial effects of arterialization of the portal vein on extended hepatectomy[J]. Br J Surg, 2000, 87(6): 784-789.
20. 　Tsivian M, Neri F, Prezzi D, et al. Portal vein arterialization in hepatobiliary surgery and liver transplantation[J]. Transplant Proc, 2007, 39(6): 1877-1878.
21. 　王鹏, 李鹏, 芮理, 等. 门静脉动脉化对肝硬化犬肝切除后肝再生的作用[J]. 世界华人消化杂志, 2009, 17(24): 2499-2502.
22. 　李坚, 关晓东, 刘琦, 等. 入肝门静脉动脉化加门腔分流对大鼠肝脏再生的影响[J]. 中山大学学报, 2010, 31(4): 508-512.
23. 　Zhang JJ, Meng XK. Current status and perspectives of application of portal vein arterialization in hepatobiliary surgery[J]. Chin J Hepatob Surg, 17(4): 349-352.
24. 　Guo SH, Li CH, Chen YL, et al. Effects of partial portal vein arterialization on the hilar bile duct in a rat model[J]. Hepatobiliary Pancreat Dis Int, 2011, 10(5): 533-538.
25. 　吴葆莹, 吴崇旭, 薛承锐, 等. 门静脉动脉化对梗阻性黄疸的临床应用[J]. 江苏医药, 2010, 36(12): 1465-1466.
26. 　Jang JS, Park DJ. Actual long-term outcome of extrahepatic bile duct Cancer after surgical resection[J]. Ann Surg, 2005, 241(1):77-84.
27. 　Parikh AA. Abdalla EK, Vauthey JN. Operative considerations in resection of hilar cholangiocarcinoma[J]. HPB, 2005, 7(4): 254-258.
28. 　沈世强, 张训臣. 肝切除时门静脉血部分动脉化的研究[J]. 中华实验外科杂志, 2000, 17(3): 235-236.
29. 　郭少华, 陈永亮, 李崇辉, 等. 部分门静脉动脉化后肝门部胆管细胞增生的试验研究[J]. 解放军医学杂志, 2010, 35(10): 1212-1214.
30. 　陈嘉伟, 唐启彬, 王捷. 门静脉动脉化对肝脏及胆管周围血管丛的影响[J]. 岭南现代临床外科, 2009, 9(5): 351-352,356.
31. 　陈永亮, 黄志强, 赵建更, 等. 部分门静脉动脉化重建肝血流的实验研究[J]. 中华普通外科杂志, 2002, 17(5): 289-290.
32. 　Schleimer K, Stippel DL, Kasper HU, et al. Portal vein arterialization increases hepatocellular apoptosis and inhibits liver regeneration[J]. J Surg Res, 2008, 149(2): 250-258.
33. 　李文岗, 黄志强, 高丽杰, 等. 门静脉动脉化后大鼠门静脉血液动力学改变对肝脏功能的远期影响[J]. 吉林大学学报·医学版, 2005, 31(2): 213-216.
34. 　Lnoue T, Sawa T, Okada S, et al. Partial portal arterialization in complete en bloc resection of the hepatoduodenal ligament and left lobe of the liver for hepatic hilar Cancer[J]. Hepatogastroenterology, 2000, 47(32): 533-536.
35. 　陈永亮, 黄志强, 王迎宾. 门静脉动脉化对实验性梗阻性黄疸大鼠肝细胞凋亡的影响[J]. 中华普通外科杂志, 2000, 15(6): 348-351.
36. 　陈永亮, 黄晓强, 黄志强, 等. 限制流量的部分门静脉动脉化重建肝血流的实验研究[J]. 解放军医学杂志, 2007, 32(3): 218-220.
37. 　陈永亮, 黄晓强, 黄志强, 等. 限制流量部分门静脉动脉化的临床应用研究[J]. 医学研究杂志, 2011, 40(9): 35-37.
38. 　陈永亮, 黄晓强, 黄志强, 等. 限制流量部分门静脉动脉化重建肝血流的临床观察[J]. 中华普通外科杂志, 2011, 26(3): 259.
39. 　李文岗, 李滨, 高丽杰, 等. 限制流量门静脉动脉化对大鼠肝脏功能和结构的远期影响[J]. 中华普通外科杂志, 2006, 21(1): 55-58.
40. 　Li WG, Chen YL, Chen JX, et al. Portal venous arterialization resulting in increased portal inflow and portal vein wall thickness in rats[J]. World J Gastroenterol, 2008, 14(43): 6681-6688.
41. 　Pastor CM. Hepatic and splanchnic oxygen consumption during acute hypoxemic hypoxia in anesthetized pigs[J]. Crit Care Med, 2000, 28(3): 765-773.
42. 　Maggi U, Camagni S, Reggiani P, et al. Portal vein arterialization for hepatic artery thrombosis in liver transplantation: a case report, Doppler-ultrasound aspects, and review of the literature[J]. Transplant Proc, 2010, 42(4): 1369-1374.
43. 　Housari G, Nuño J, Calero P, et al. Portal vein arterialization in liver transplantation: an option to restore arterial flow: a case report[J]. Transplant Proc, 2011, 43(3): 755-757.
44. 　Bonnet S, Sauvanet A, Bruno O, et al. Long-term survival after portal vein arterialization for portal vein thrombosis in orthotopic liver transplantation[J]. Gastroentérologie clinique et biologique, 2010, 34(1): 23-28.
45. 　Li Destri G, La Greca G, Greco L, et al. Arterialization of the portal stump by right renal artery after portocaval shunt in the rat[J]. Microsurgery, 2004, 24(1): 77-80.
46. 　Chen YL, Li WG, Huang ZQ, et al. Effects of portal venous arterialization on acute occlusion of hepatic artery in rats[J]. Chin Med J (Engl), 2008, 121(14): 1302-1306.

West China Medical Journal

门静脉动脉化在肝门胆管癌根治术中的应用研究进展

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