肝动脉-腹主动脉搭桥在原位肝移植术中的应用

Application of Hepatic Artery Reconstruction with Iliac Arterial Interposition Graft in Orthotopic Liver Transplantation

目的探讨供肝动脉与受体肾动脉下的腹主动脉之间用同一供体的骼动脉进行搭桥的方法及其相关并发症的影响因素。方法回顾性分析8例使用同一供体的髂动脉进行肾动脉平面以下肝动脉-腹主动脉搭桥的肝移植术临床资料。结果8例患者术中肝动脉-腹主动脉搭桥用时53～126min，术后发生胆瘘1例，胆道感染并肝内胆汁瘤形成1例，其余6例患者恢复顺利，肝功能1周左右恢复正常；无肝动脉并发症发生。结论使用供体髂血管进行肝动脉-腹主动脉搭桥，对于无法行常规肝动脉吻合的受体是一种安全、有效的方法。

Objective To explore the methods of hepatic artery reconstruction with iliac arterial interposition graft in orthotopic liver transplantation （OLT） and influential factor of relevant complications postoperatively. Methods Analyzed retrospectively 80LT, the hepatic artery reconstruction with arterial inflow based on recipient infrarenal aorta using donor iliac artery graft tunneled through the transverse mesocolon and pancreas. Results The time required for hepatic artery reconstruction with iliac arterial interposition graft was 52- 126 minutes. Among the 8 patients, 2 patients developed postoperative bililary tract complications, 1 with biliary fistula, 1 with intrahepatic biloma, the others were recovered smoothly and liver function returned to normal about one week after liver transplantation. No complications of hepatic artery were observed. Conclusion Iliac arterial interpositional graft is an effective and reliable method of revascularization in liver transplantation when the use of hepatic artery is not possible.