中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (03): 211-213.

• 论著 • 上一篇    下一篇

背驮式肝移植肝静脉成形重建对移植肝流出道影响的研究

王孟龙,卢实春,池    萍,朱    岳, 李    宁   

  1. 首都医科大学附属北京佑安医院肝移植中心,北京100069
  • 出版日期:2010-03-01 发布日期:2010-03-12

  • Online:2010-03-01 Published:2010-03-12

摘要:

目的    探讨肝静脉成形法在背驮式肝移植对移植肝流出道的影响。方法    从2004年至2008年11月间,北京佑安医院肝移植中心共实施303例原位肝移植,其中采用肝静脉成形法重建移植肝流出道者占84例,回顾总结这84例病人移植肝回流情况以及该手术方式对无肝期血流动力学影响。结果    采用背驮式肝移植病人,在无肝期的下腔静脉压力升高显著低于单纯经典原位肝移植而与经典原位加腔静脉转流术式相当。所有 84例背驮式肝移植病人术后无一例发生肝静脉流出道梗阻并发症,也无一例因该术式发生急性肾功能衰竭。 结论 肝静脉成形重建移植肝流出道术式尤适合于对血流动力学要求较高的危重症肝移植病人而无流出道梗阻之虞。

关键词: 肝静脉成形, 背驮式肝移植, 移植肝流出道

Abstract:

Hepatic vein plasty for reconstructing graft outflow in Piggy-backy liver transplantation        WANG Meng-long, LU Shi-chun, CHI Ping, et al. Liver Transplantation Center, Beijing You'an Hospital, Capital University of Medical Sciences, Beijing 100069, China
Corresponding author:WANG Meng-long,E-mail: mlwangwangml2000@yahoo.com
Abstract Objective To investigate the effect of the hepatic vein plasty on the graft outflow in piggy-back liver transplantation. Methods    303  orthotopic liver transplants were performed between June 2004 and November 2008. Piggy-back technique with hepatic vein plasty was used in 84 cases. Results    Inferior caval vein  pressures were significantly increased less in piggy-back liver transplantation than those in conventional technique without venovenous bypass , but comparable to those with venovenous bypass during anhepatic phase. No hepatic venous outflow obstruction was encountered after piggy back liver transplantation with hepatic vein plasty, and no acute renal failure developed because of this technique. Conclusion    Hepatic vein plasty in piggy back liver transplantation is especially applicable to the patients with serious liver diseases requiring stable systemic hemodynamics, and with no worry about graft outflow obstruation.

Key words: hepatic vein plasty, piggy-back liver transplantation; graft outflow.