临床活体肝部分移植术受体的手术技巧

Surgical techniques of recipient operation in living related liver transplantation

目的探讨活体肝部分移植术受体手术技巧。方法以在京都大学留学时经治的１０例患者为对象，介绍肝部分移植受体手术各个环节的操作方法及注意事项。结果１０例中男３例，女７例。年龄３个月～１２岁。９例施行肝左外叶移植术，１例施行肝左叶移植术。手术时间１０～１５ｈ，出血量１０００ｍｌ左右，无肝期９０～１２０ｍｉｎ。手术顺利，全部受体顺利康复。结论受体手术应从手术切口选择、肝脏游离、肝门显露及解剖、短肝静脉和肝静脉的处理、血管和胆管的重建、创面处理及引流等加以把握。

Objective To investigate the surgical techniques of recipient operation in living related liver transplantation (LRLT). Methods Ten cases of LRLT managed by the authors in Kyoto University were analysed, and the operative procedures of each stage were introduced in detail. Results There were 3 males and 7 females with ages ranging from 3 months to 12 years. Hepatic left lateral lobe transplantation was perfomed in 9 cases and hepatic left lobe transplantation in 1 case. The operation time lasted 10～15 hours with about 1000ml of bleeding; non liver period lasted for 90～120 minutes. The operations were uneventful, all of the cases recovered smoothly. Conclusions Such aspects as incisional selection, liver separation, hepatic porta exposure and anatomization, management of hepatic veins, reconstruction of artery and bile dult, management of surface wound and drainage should be emphasized in recipient operation.