胎儿肝脏的整修

THE TECHNIQUES OF FETAL LIVER PREPARATION

胎儿肝脏的整修是辅助性胎肝移植的重要环节之一，它直接关系到植入肝脏的质量和移植效果。为取得临床前的胎肝整修经验，对２０例脑死亡胎儿的肝脏采用原位灌注，腹腔多器官联合切取后在冰水盆内整修。结果表明肝动脉解剖游离复杂费时，应注意有无肝动脉解剖变异存在。胎肝门静脉血供的建立，选择脐静脉为宜，但应结扎脐静脉导管。肝静脉流出道可选择肝上或肝下下腔静脉。胆道重建用胎儿胆囊作吻合。

The preparation of a fetal liver graft may be one of the most important events for auxiliary fetal liver transplantation, and it related directly to the quality of engrafted liver and the result of operation. In order to accumulate the preclinical experience of fetal liver preparation, we conducted the procedure on 20 cases of fetal liver with brain death after perfusion in situ and combined procurement of multiple abdominal organ. The result demonstrated that the dissection of hepatic artery was sophisticated and very time-consuming proceduce. In the cause one should pay more attention to hepatic artery variation. We thought the umbilical vein was much more suitable for vein blood supply than portal vein, but the vein duct should be ligated. In our experiment either suprahepatic vena cava or infrahepatic vena cava was chosed as the efferent vessel from donor liver and the fetal gallbladdercould be used for bile duct reconstruction.