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Improved liver donor treatment reduced biliary complications after liver transplantation
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF ORGAN TRANSPLANTATION
- Issue:
- 5
- DOI:
- 10.3760/cma.j.issn.0254-1785.2007.05.003
- Key Word:
- 肝移植;手术后并发症;胆道疾病
Abstract： 目的 改进供肝处理方法,以减少肝移植术后的胆道并发症. 方法 供肝处理进行如下改进:(1)肝门游离仅达胃十二指肠动脉下缘,不游离其上方的肝蒂结构;(2)修整供肝时暂不结扎胃十二指肠动脉本身的断端;(3)修整供肝时暂不切除胆囊,待供肝植入、肝动脉重建后切除.共行99例肝移植,患者的原发病,58%为良性肝病,42%为肝癌.供肝热缺血和冷缺血时间分别控制在5min和16 h以内.胆道重建方式均为胆总管-胆总管端端吻合,其中5例放置T管.观察术后早期胆道并发症的发生情况. 结果 4例(4%,4/99)肝移植术后发生胆道并发症,其中1例术后10 d发现胆道吻合口漏;1例术后5个月胆道内有胆树形成;1例为胆道吻合口狭窄;1例为左肝管狭窄.改进前的肝移植术后早期胆道并发症发生率为11.6%(5/43). 结论 通过改进供肝的处理方法,可最大限度地保留供肝胆道血液供应,显著减少术后胆道并发症.
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