肝移植术后再手术原因分析

Analysis of the causes of re-operation after liver transplantation

目的探讨肝移植术后再手术的原因。方法回顾性分析2002年6月至2006年6月,上海交通大学医学院附属瑞金医院肝移植术后再次手术的27例病人的临床资料。结果27例病人术后行32次再手术,其中5例行2次再手术,再手术率为14.2%。再手术的原因包括:腹腔内出血17例次,占再手术总例次的53.1%;胆道并发症11例次,占再手术总例次的34.3%;肝动脉栓塞2例次,占再手术总例次的6.3%;其他2例次,包括上消化道出血1例、胸腔出血1例,占再手术总例次的6.3%。27例病人中,7例再手术后死亡,病死率为25.9%。结论肝移植术后再手术的原因是多方面的,其中腹腔内出血及胆道并发症是其两大主要原因。正确认识肝移植术后再手术的原因,对降低肝移植病人术后病死率具有重要意义。

Objective To study the causes of re-operation after liver transplantation （LT）. Methods Two hundreds and twenty-five patients were performed LT from June 2002 to June 2006 in Rui Jin Hospital Affiliated to Medical college of Shanghai Jiao Tong University. Among them,27 patients were performed re-operation after LT. The clinical data of the 27 patients were analyzed retrospectively. Results Thirty-two times of re-operation were performed in the 27 patients and the incidence of re-operation was 14. 2%. The causes of re-operation included as following： intra-abdominal bleeding in 17 cases （53.1%） ,biliary complications in 9 cases （ 11 times,34. 3% ） ,hepatic artery thrombosis in 2 cases （6. 3% ）, upper gastrointestinal bleeding in 1 case and thorax bleeding in 1 case. Among 27 patients ,7 patients died after re-operation with the mortality of 25.9%. Conclusions The causes of re-operation after LT are various. Intra-abdominal bleeding and biliary complications are the major factors. Recognizing the causes of re-operation after LT is very important to decrease the mortality after LT.