肝动脉变异与肝移植

Anatomical Variation of Hepatic Artery and Liver Transplantation

目的总结肝移植中供体及受体肝动脉变异情况与重建方式。方法回顾我院2002年3月～2005年12月107例肝移植供体与107例受体肝动脉变异情况及重建方式。术后应用Doppler超声、胆道镜及介入方法监测肝动脉及胆道并发症的发生情况。结果107例肝移植之供、受体肝动脉(214例肝动脉),3例术中、术后死于多器官功能衰竭,有20例次肝动脉变异,经过术中良好的重建,其结果显示肝动脉及胆道并发症3例(3/19),较正常肝动脉吻合者(15/85)无显著性差异(P>0.05)。结论肝动脉变异发生率约9.35%左右,肝移植时供肝切取、修整及受体病肝切除应引起高度重视,术中良好的重建能取得好的效果。

Objective To study the effects of anatomical variation of hepatic artery and their reconstruction methods on orthotopic liver transplantation. Method The variation of hepatic artery and approach of reconstruction were studied retrospectively on 107 donors and 107 recipients of orthotopic liver transplantation from March 2002 to December 2005 The complications of hepatic artery and biliary were assessed by Doppler ultrasound, endoscopy and interventional therapy after operations. Results 20 anatomical variations of hepatic artery were found during organ procurement and back-table in the 107 cases, which were reconstructed. No significant differences were found between the normal hepatic artery cases and the cases with hepatic arterial variations in terms of hepatic artery and biliary complications （ P 〉 0.05 ）. Conclusions The incidence of anatomical variation of hepatic artery was about 9.35 percent. Attention should be paid to the anatomical variation of hepatic artery during liver procurement and implantation. Satisfactory prognosis could be achieved provided that a well reconstruction of the hepatic artery should be done in these variation cases.