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【文摘发布】安全的肝外科手术策略与部分肝移
Author：Pierre-Alain Clavien, M.D., Ph.D., Henrik Petrowsky, M.D.,et al.From the Swiss Hepato-Pancreatico-Biliary (HP Center, Department of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland.
Source：T h e new engl and journa l o f medicine， Volume 356:1545-1559 April 12, 2007 Number 15
Conclusion：There has been substantial progress in both liver surgery and liver transplantation owing to improved preoperative diagnosis and intraoperative and postoperative care. Factors that limit the achievement of curative tumor resection are the
high morbidity and mortality rates associated with insufficient volume of the liver remnant.Many tumors that were previously considered to be unresectable are now amenable to complete resection through innovative strategies that make manipulation of the liver volume possible. Portalvein embolization or ligation causes atrophy of the ipsilateral hemiliver and hypertrophy of the contralateral side. Portal-vein embolization appears
to be particularly valuable in patients who have underlying liver disease. The concomitant administration of chemotherapy may further decrease both the tumor load and postoperative recurrences.The use of partial liver transplantation is also rapidly increasing, as transplantation surgeons and hepatologists attempt to overcome the worldwide
shortage of organs available for transplantation.Unfortunately, there is still a need for a substantial graft volume to support life, which places healthy donors at substantial risk. In the future, the use of new drugs based on innovative experimental models, together with a better understanding of the pathways leading to liver regeneration, may permit a very small liver remnant to regenerate, resulting in safer surgery for living donors and for patients with large tumors.
这是一篇综述，我选取结论部分，供肝移植的朋友参阅。
http://content.nejm.org/cgi/content/extract/356/15/1545?andorexacttitleabs=and&search_tab=articles&tocsectionid=Original+Articles&tocsectionid=Special+Reports&tocsectionid=Special+Articles&tocsectionid=Videos+in+Clinical+Medicine&tocsectionid=Clinical+PracticeAORBClinical+Therapeutics&tocsectionid=Review+ArticlesAORBClinical+PracticeAORBClinical+Implications+of+Basic+ResearchAORBMolecular+MedicineAORBClinical+TherapeuticsAORBVideos+in+Clinical+Medicine&tocsectionid=EditorialsAORBPerspectiveAORBOutlookAORBBehind+the+Research&tocsectionid=Sounding+BoardAORBClinical+Debate&tocsectionid=Clinical+Implications+of+Basic+Research&tocsectionid=Health+Policy+ReportsAORBHealth+Policy+2001AORBQuality+of+Health+Care&tmonth=Apr&searchtitle=Articles&sortspec=Score+desc+PUBDATE_SORTDATE+desc&excludeflag=TWEEK_element&hits=20&where=titleabstract&tyear=2007&andorexactfulltext=and&fyear=1997&fmonth=Apr&sendit=GO&searchterm=partial+liver+transplantation&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Title：Strategies for Safer Liver Surgery and Partial Liver Transplantation。
安全的肝外科手术策略与部分肝移植 背景资料：
编译中的“ 肝细胞能迅速再生，使得肝移植和肝脏手术策略能发展，而肝的解剖学的分段等对手术又有利，但是肝细胞再生的机制仍然不是十分明朗。在年龄小于40岁的有正常肝实质的肝肿瘤患者行肝脏手术最多能切除75%左右，剩余肝体积依然限制着肝脏手术难题依然存在。” 背景资料：
编译中的“ 肝细胞能迅速再生，使得肝移植和肝脏手术策略能发展，而肝的解剖学的分段等对手术又有利，但是肝细胞再生的机制仍然不是十分明朗。在年龄小于40岁的有正常肝实质的肝肿瘤患者行肝脏手术最多能切除75%左右，剩余肝体积依然限制着肝脏手术难题依然存在。” 附上原文如下：part03
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作者:admin@医学,生命科学 2011-06-21 05:11
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