改良背驮式肝移植临床应用研究

THE STUDY OF COUNTERMEASURE FOR CLINICAL DIFFICULT PIONTS IN THE PIGGY-BACK ORTHOTOPIC LIVER TRANSPLANTATION OPERATION

目的 探讨在背驮式原位肝移植病肝切除过程中应用常温下全肝血流预阻断 (放置阻断带 )的方法以及新肝置入术中改良肝上下腔静脉侧侧吻合方法以预防术中凶险性出血及确保新肝流出道通畅难点问题的临床意义。方法 1 0例背驮式原位肝移植受体病肝切除及新肝置入时均采用了常温下全肝血流预阻断及改良的肝上下腔静脉侧侧吻合方法完成。 结果 1 0例患者手术顺利完成。结论 常温下全肝血流放置预置带预阻断的方法是避免受体病肝切除过程中凶险性出血的安全而有效的方法。改良受体肝上下腔静脉侧侧吻合是保证新肝流出道通畅的一简便而有效的措施。

Objective To explore clinical significance that technique of total vascularpreparative exclasion in normoth ermia andmodified side side anastomosis of inferiorvena cave were used for preverting severe hemorrhage and assuring unob structed anastomostic stoma.Methods During the resection of diseased liver,the techique oftotal vascular preparative exclu sion in nomothermia was used.During the replacement of the new liver,the modified side side anastomosis of inforior vena cave was performed.Results The ten patients recovered very well postoperatively.Conclusion The appliation of techique of total asular preparative exclusion and modified side side anastomosis of inferior vena cave are simple secure effective meth ods for assuring successful operation in the piggy back orthotopic liver transplantation.