摘要
目的探讨4种不同肝移植手术方式的优缺点及适应证。方法对实施成人尸体全肝移植的135例患者分别采用4种不同术式:A组(22例)采用经典原位肝移植,B组(79例)采用改良背驮式,C组(18例)采用经典背驮式肝移植,D组(16例)采用改良的经典原位肝移植,所有患者术中均未行体外静脉转流,回顾性分析135例患者的术中、术后情况。结果各组间手术时间、无肝期时间和术中出血量差异具有显著性(P<0.05),术后一过性肾功能损害的发生率C组较其他各组显著降低(P<0.05),手术后近期生存率及血管并发症各组间差异无显著性。结论应针对患者具体情况选择不同手术方式,对于一些肿瘤患者或有上腹部手术史的患者,采用改良的经典原位肝移植可以缩短手术时间,尤其是无肝期时间,减少手术难度和术中出血量,改善患者预后。
Objective To compare the advantages and disadvantages of four surgical techniques in orthotopic liver transplantation.Methods A total of 135 adult recipients receiving cadaveric whole liver grafts were dividied into four groups according to the surgeries they received: group A(n=22) underwent classic orthotopic liver transplantation,group B(n=79) underwent modified piggyback liver transplantation,group C(n=18) underwent classical piggyback liver transplantation,and group D(n=16) underwent modified classic orthotopic liver transplantation.The clinical data of these recipients were retrospectively analyzed.Results The operation time,anhepatic time,and intra-operation bleeding volume among these four groups were significantly different(P〈0.05).The incidence of transient renal damage in group C was significantly lower than that in other groups(P〈0.05),while the complication rates and survival rates were not significantly different in the early stage after the operation.Conclusions Surgery techniques should be carefully selected based on the individual patients's pre-operative condition.The modified classic orthotopic liver transplantation is a preferred technique for tumor patients or patients with surgical history of upper abdomen.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2008年第4期426-429,共4页
Acta Academiae Medicinae Sinicae
基金
美国中华医学基金会基金(06-837)
广州市科技攻关项目(2006Z3-E0031)~~
关键词
肝移植
手术方式
预后
liver transplantation
surgical technique
prognosis