原位肝移植供肝血管及胆道修整

Experience of management of donor liver vessels and biliary tracts in orthotopic liver transplantation

目的探讨原位肝移植供肝血管及胆道系统的修整处理方法。方法回顾性分析31例原位肝移植其供肝动脉变异及胆道内异常情况的处理资料。结果肝动脉变异5例,其中2例肝左动脉来自胃左动脉,2例肝右动脉来自肠系膜上动脉,1例肝总动脉来自肠系膜上动脉。来自肠系膜上动脉的2例肝右动脉,1例吻合到脾动脉的断端;另1例将腹腔干吻合到肠系膜上动脉的近端。供肝的肝内胆管行冲洗时发现有寄生虫2例。结论避免变异的供肝动脉损伤,选择适当的肝动脉吻合方式可以保证移植肝脏的动脉血供。正确的供肝胆道处理,可以减少胆道的并发症。

Objective To investigate reconstructing methods and management of donor liver vessels and biliary tracts in orthotopic liver transplantation. Methods A retrospective analysis was made for 31 cases donor liver vessels and biliary tracts in orthotopie liver transplantation（OLT）. Results Anatomic variations of hepatic artery was found in 5 cases among 31 donors, left hepatic artery originating from left gastric artery（2 cases）, right hepatic artery originating from the superior mesenteric artery（ 2 cases） and common hepatic artery originating from the superior mesenterie artery（ 1 cases）. Parasites were found in intrahepatic bile duct for two cases. Conclusion There is no increased incidence of hepatic artery and hiliary tract complications in the presence of hepatic artery and biliary tract anomalies in the donor, if only dealing with variations of the donor hepatic artery and biliary tracts exactly,