中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (01): 80-82.

• 论著 • 上一篇    下一篇

活体肝移植供体手术及术后管理（附22例临床分析）

王    东，栗光明，朱继业，胡志平，冷希圣   

  1. 北京大学人民医院肝胆外科 北京大学器官移植中心, 北京 100044
  • 出版日期:2011-01-01 发布日期:2011-05-30

  • Online:2011-01-01 Published:2011-05-30

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摘要：

目的    探讨提高活体肝移植供体手术安全性和加强术后管理的措施。方法    回顾性分析北京大学人民医院2003年2月至2009年6月22例活体肝移植供体的临床资料，总结供体术前评估、手术技术、术后并发症及随访情况。结果    术前对供体进行三步法评估，术中采用超吸刀 （CUSA）进行肝脏实质分离，术后定期随访。供肝移植物包括肝左外叶2例、左半肝6例、扩大左半肝1例、右半肝5例和扩大右半肝8例。1例在术后早期出现腹腔内出血，1例合并胸水，1例枕后皮下血肿，其他供体未出现严重并发症，术后肝功能迅速恢复正常，随访至今无供体死亡。结论    活体肝移植供体手术复杂，严格术前评估，术中精细操作，术后加强随访是提高活体肝移植供体安全的重要保证。

关键词: 活体肝移植, 供体, 并发症

Abstract:

Clinical analysis of donor hepatectomy and postoperative management in 22 cases of living donor liver transplantation        WANG Dong，LI Guang-ming，ZHU Ji-ye，et al. Department of Hepatobiliary Surgery，Peking University People’s Hospital，Peking University Center of Transplantation，Beijing 100044，China
Corresponding author: ZHU Ji-ye, E-mail: gandanwk@vip.sina.com
Abstract    Objective    To improve the safety of donor surgery and enhance the postoperative management of liver donors in living donor liver transplantation (LDLT). Methods    The clinical data was retrospectively analyzed in 22 cases of LDLT donnor surgery were performed from February 2003 to June 2009 in Peking University People’s Hospital,preoperative evaluation, surgical technigue, postoperative complications and outcome were retrospectively analyzed. Results    Three steps of preoperative evaluation were used, Ultrasonic Dissector (CUSA) was applied in donor hepatectomy and all of the donors were followed up after operation. Totally, 2 left lateral hepatic lobes, 6 cases of left hepatic lobes, 1 extended left hepatic lobe, 5 right hepatic lobes and 8 cases of extended right hepatic lobes were harvested. No complication except 1 case of intra-abdominal bleeding, 1 case of hydrothorax and 1 case of ecchymoma was found. Hepatic function restored to normal soon and no death occured. Conclusion    Strict preoperative evaluation, precise surgical technique and routine follow up are guarantees of donor safety in LDLT.

Key words: living donor liver transplantation, donor, complications