妊娠期肝手术保护胎儿：腔静脉旁路术的作用。

IF 2.4 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology Pub Date : 2025-09-29 DOI:10.1016/j.clinre.2025.102701

Arthur Marichez , Nour Aldajani , Catherine Fleureau , Jean-Philippe Adam , Brigitte Le Bail , Hugo Madar , Loïc Sentilhes , Laurence Chiche

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引用次数: 0

摘要

背景：妊娠期间发现肝脏肿块需要仔细的病因评估。一名29岁的女性在妊娠24周时被诊断为17厘米的炎性肝细胞腺瘤。考虑到自发性破裂和出血的高风险，一个多学科团队在26周时选择了右肝切除术。为了保持母体血流动力学稳定，避免胎儿血流灌注不足，我们建立了静脉-静脉腔-腔分流术，在全血管排除的情况下切除肝脏，血压无波动。整个过程很顺利，足月生下了一个健康的孩子。在肝切除术期间，使用腔静脉旁路提供了一种稳定母体循环和保护胎儿健康的保护策略。

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Protecting the fetus during hepatic surgery in pregnancy: the role of cavo-caval bypass

Background

The discovery of a liver mass during pregnancy requires careful etiological assessment.A 29-year-old woman was diagnosed with a 17-cm inflammatory hepatocellular adenoma at 24-weeks of gestation. Given the high risk of spontaneous rupture and bleeding,a multidisciplinary team opted for a right hepatectomy at 26-weeks. To maintain stable maternal hemodynamics and avoid fetal hypoperfusion, a veno-venous cavo-caval bypass was established, allowing liver resection under total vascular exclusion without blood pressure fluctuations. The procedure was uneventful and a healthy child was delivered at term. The use of cavo-caval bypass offers a protective strategy to stabilize maternal circulation and preserve fetal well-being during major hepatectomy.

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来源期刊

Clinics and research in hepatology and gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.30

自引率

3.70%

发文量

198

审稿时长

42 days

期刊介绍： Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.