肝全摘、肝全摘術

WordNet

determine the sum of; "Add all the people in this town to those of the neighboring town" (同)tot, tot up, sum, sum_up, summate, tote up, add, add together, tally, add up
damage beyond the point of repair; "My son totaled our new car"; "the rock star totals his guitar at every concert"
add up in number or quantity; "The bills amounted to $2,000"; "The bill came to $2,000" (同)number, add up, come, amount
a small amount (especially of a drink); "a tot of rum"
used of automobiles; completely demolished; "the insurance adjuster declared the automobile totaled"

PrepTutorEJDIC

『総計の』,全体の / 『全くの』,完全な(absolute) / 『合計』,総額,総数,総量(sum) / …‘を'合計する / 合計…‘に'なる,総額が…‘に'のぼる(amount to)
幼児,小児 / (特に酒類の)少量,一杯,一口
…‘を'合計する《+up+名,+名+up》 / 合計(…に)なる《+up to+名》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/02 15:19:25」(JST)

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Hepatectomy is the surgical resection of the liver. While the term is often employed for the removal of the liver from a liver transplant recipient, this article will focus on partial resections of hepatic tissue and hepatoportoenterostomy.

History

The first hepatectomies were reported by Ichio Honjo (Kyoto University) in 1949,^[1] and Jean-Louis Lortat-Jacob in 1952.^[2] In the latter case, the patient was a 58-year-old woman diagnosed with colorectal cancer which had metastasized to the liver.

Indications

Most hepatectomies are performed for the treatment of hepatic neoplasms, both benign or malignant. Benign neoplasms include hepatocellular adenoma, hepatic hemangioma and focal nodular hyperplasia. The most common malignant neoplasms (cancers) of the liver are metastases; those arising from colorectal cancer are among the most common, and the most amenable to surgical resection. The most common primary malignant tumour of the liver is the hepatocellular carcinoma. Hepatectomy may also be the procedure of choice to treat intrahepatic gallstones or parasitic cysts of the liver. Partial hepatectomies are also performed to remove a portion of a liver from a live donor for transplantation.

Technique

A hepatectomy is considered a major surgery done under general anesthesia. Access is accomplished by laparotomy, typically by a bilateral subcostal ("chevron") incision, possibly with midline extension (Calne or "Mercedes-Benz" incision). An anterior approach, one of the most innovative, is made simpler by the liver hanging maneuver.^[3] Hepatectomies may be anatomic, i.e. the lines of resection match the limits of one or more functional segments of the liver as defined by the Couinaud classification (cf. liver#Functional anatomy);^[4] or they may be non-anatomic, irregular or "wedge" hepatectomies. Anatomic resections are generally preferred because of the smaller risk of bleeding and biliary fistula; however, non-anatomic resections can be performed safely as well in selected cases.^[5]

The Pringle manoeuvre is usually performed during a hepatectomy to minimize blood loss - however this can lead to reperfusion injury in the liver due to Ischemia.^{[citation needed]}

Complications

Bleeding is the most feared technical complication and may be grounds for urgent reoperation. Biliary fistula is also a possible complication, albeit one more amenable to nonsurgical management. Pulmonary complications such as atelectasis and pleural effusion are commonplace, and dangerous in patients with underlying lung disease. Infection is relatively rare.^{[citation needed]}

Liver failure poses a significant hazard to patients with underlying hepatic disease; this is a major deterrent in the surgical resection of hepatocellular carcinoma in patients with cirrhosis. It is also a problem, to a lesser degree, in patients with previous hepatectomies (e.g. repeat resections for reincident colorectal cancer metastases).^{[citation needed]}

Results

Liver surgery is safe when performed by experienced surgeons with appropriate technological and institutional support. As with most major surgical procedures, there is a marked tendency towards optimal results at the hands of surgeons with high caseloads in selected centres (typically cancer centres and transplantation centres).^{[citation needed]}

For optimal results, combination treatment with systemic or regionally infused chemo or biological therapy should be considered. Prior to surgery, cytotoxic agents such as oxaliplatin given systemically for colorectal metastasis, or chemoembolization for hepatocellular carcinoma can significantly decrease the size of the tumor bulk, allowing then for resections which would remove a segment or wedge portion of the liver only. These procedures can also be aided by application of liver clamp (Lin or Chu liver clamp; Pilling no.604113-61995) in order to minimize blood loss.^{[citation needed]}

Etymology

The word "hepatectomy" is a fusion of Latin and Greek. In Latin, liver is hēpaticus, and -ectomy comes from the Greek ektomē, "to remove."^{[citation needed]}

References

^ Tsuchiya, Ryoichi (2002). "我が国の肝膵外科学 : 1.本庄一夫記念シンポジウムによせて(<特集>創造と調和" [Surgery of the liver and pancreas in Japan--message to the special symposium commemorating Dr. Ichio Honjo]. Nihon Geka Gakkai Zasshi (in Japanese) 103 (3): 318–21. PMID 11968765.
^ Lortat-Jacob, JL; Robert, HG (1952). "Hépatectomie droite réglée" [Well defined technique for right hepatectomy]. La Presse Médicale (in French) 60 (26): 549–51. PMID 14948909.
^ Liddo, Guido; Buc, Emmanuel; Nagarajan, Ganesh; Hidaka, Masaaki; Dokmak, Safi; Belghiti, Jacques (2009). "The liver hanging manoeuvre". HPB 11 (4): 296–305. doi:10.1111/j.1477-2574.2009.00068.x. PMC 2727082. PMID 19718356.
^ Knipe, Henry; Jones, Jeremy. "Couinaud classification". UBM Medica Network. Retrieved 2 December 2014.
^ International Hepato-Pancreatico-Biliary Association (IHPBA) Terminology for Liver Resections

External links

Oncolex, the cancer encyclopedia, on liver cancer
Video showing laprascopic liver resection.
The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery – Video of Extended Left Hepatectomy procedure
The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery – Video of Standard Left Hepatectomy procedure
The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery – Video of Standard Right Hepatectomy procedure
The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery – Video of Laparoscopic Right Hepatectomy procedure

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 肝障害のマネージメントのための外科手技 surgical techniques for managing hepatic injury
2. 肝切除の概要 overview of hepatic resection
3. 全人工股関節置換術 total hip arthroplasty
4. 胃全摘術および消化管再建術 total gastrectomy and gastrointestinal reconstruction
5. 重度の関節リウマチに対する全関節置換術 total joint replacement for severe rheumatoid arthritis

English Journal

Management of Biliary Cystic Tumors: A Multi-institutional Analysis of a Rare Liver Tumor.

Arnaoutakis DJ1, Kim Y, Pulitano C, Zaydfudim V, Squires MH, Kooby D, Groeschl R, Alexandrescu S, Bauer TW, Bloomston M, Soares K, Marques H, Gamblin TC, Popescu I, Adams R, Nagorney D, Barroso E, Maithel SK, Crawford M, Sandroussi C, Marsh W, Pawlik TM.
Annals of surgery.Ann Surg.2015 Feb;261(2):361-7. doi: 10.1097/SLA.0000000000000543.
OBJECTIVE: To characterize clinical and radiological features associated with biliary cystic tumors (BCTs) of the liver, and to define recurrence-free and overall survival.BACKGROUND: Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC) are rare tumors that arise in the liver.METHODS: Bet
PMID 24509187

A new rat model of auxiliary partial heterotopic liver transplantation with liver dual arterial blood supply.

Qiao J1, Han C2, Zhang J3, Wang Z3, Meng X1.
Experimental and therapeutic medicine.Exp Ther Med.2015 Feb;9(2):367-371. Epub 2014 Dec 5.
Auxiliary partial heterotopic liver transplantation (APHLT) with portal vein arterialization is a valuable procedure to be considered in the treatment of patients with acute liver failure and metabolic liver diseases. The aim of this study was to develop a new rat model of APHLT with liver dual arte
PMID 25574199

Volumetric analysis and indocyanine green retention rate at 15 min as predictors of post-hepatectomy liver failure.

Kim HJ1, Kim CY, Park EK, Hur YH, Koh YS, Kim HJ, Cho CK.
HPB : the official journal of the International Hepato Pancreato Biliary Association.HPB (Oxford).2015 Feb;17(2):159-67. doi: 10.1111/hpb.12295. Epub 2014 Jun 25.
OBJECTIVES: The actual future liver remnant (aFLR) is calculated as the ratio of remnant liver volume (RLV) to total functional liver volume (TFLV). The standardized future liver remnant (sFLR) is calculated as the ratio of RLV to standard liver volume (SLV). The aims of this study were to compare t
PMID 24964188