离体肝切除联合自体肝移植在肝脏良性病变中的治疗现状

Abstract

肝脏良性病变主要包括肝血管瘤、肝局灶性结节性增生、肝细胞腺瘤、肝血管平滑肌脂肪瘤等，肝泡型棘球蚴病属于寄生虫病的一种类型，因其主要发生在肝脏中，也属于肝脏良性病变。肝脏良性病变临床治疗上多以随访观察为主，手术切除为辅，对于终末期的患者，若病灶体积过大、侵犯周围大血管较多、解剖位置不清晰或术中无法避免破裂大出血，可行肝移植治疗。由于器官捐献肝脏分配评分中肝功能较差的患者更易得到供肝，肝脏良性病变由于自身生长方式很难获得相应的供肝资源，故导致同种异体肝移植对其应用有限。离体肝切除联合自体肝移植自20世纪80年代出现以来，给此类患者的治疗带来了一种全新的方式。本文就目前离体肝切除联合自体肝移植在肝脏良性病变的应用现状加以总结，旨在为临床医务人员提供相应的诊治参考。

Alternate abstract:

Benign liver lesions mainly include hepatic hemangioma, focal nodular hyperplasia of the liver, hepatocellular adenoma, and hepatic angiomyolipoma. Hepatic alveolar echinococcosis is a type of parasitic disease, and since it mainly occurs in the liver, it is also a benign lesion of the liver. The clinical treatment of benign liver lesions is mainly based on follow-up observation, supplemented by surgical resection. For patients with end-stage diseases, liver transplantation can be performed due to the large volume of the lesion, the invasion of a number of surrounding large vessels, unclear anatomic location, and the possibility of intraoperative rupture and massive hemorrhage. Since patients with poor liver function based on the liver allocation score for organ donation are more likely to get donor liver, it is difficult for patients with benign liver lesions to obtain the corresponding donor liver resources due to the growth pattern of benign liver lesions, thereby leading to the limited application of allogeneic liver transplantation. Since its emergence in the 1980s, ex vivo liver resection and autotransplantation (ELRA) has brought a new way for the treatment of such patients. This article summarizes the current application of ELRA in benign liver lesions, in order to provide a reference for diagnosis and treatment by clinical medical staff.