改进的门静脉套管置入技术在大鼠肝移植中的应用

A modified cuff insertion technique for portal vein anastomoses in rat liver transplantation

目的探讨改进的门静脉套管置入技术“门脉分支悬吊法”在大鼠肝移植门静脉重建中的应用效果。方法“双袖套法”建立大鼠肝移植模型，分别应用改进的“门脉分支悬吊法”和传统方法行受体门静脉重建，比较门静脉重建所需时间和成功率、无肝期时间以及移植手术成功率。结果应用改进的“门脉分支悬吊法”行大鼠肝移植（n=35），受体门静脉重建成功率94．3％，门静脉吻合所需时间仅为（1．9±0．7）min，无肝期为（21．8±2．2）min，移植手术成功率为80％，优于传统方法（P〈0．05）。术后1周存活率为85．8％，与传统方法比较无统计学差异（P〉0．05）。结论改进的“门脉分支悬吊法”缩短了受体门静脉吻合时间和无肝期，提高了门静脉重建成功率和移植手术成功率，可以快速、安全地实现大鼠肝移植受体手术中的门脉套管置入和门静脉重建。

Objective To investigate the effect of a modified cuff insertion technique named ＂portal vein branch-sling＂ （PBS） method for portal vein （PV） anastomoses in rat liver transplantation. Methods A total of 60 cases of orthotopic liver transplantation （OLT） using 2-cuff technique in rats were performed in our transplantation center. The PBS technique and conventional methods were used respectively in study and control groups. Time for PV anastomoses, anhepatic phase （AP） and surgery of recipients, successful rate for PV cuff insertion and operation were statistically compared between the different groups. Results 35 cases of OLT using PBS technique in rats were assessed. The successful rate of PV cuff insertion was 94.3 %, and the time of PV anastomoses using the modified PBS cuff insertion technique was only 1.9 ± 0.7min. The successful rate of operation was 80 with a 21.8±2.2min AP. The study group showed significant differences （P〈0.05） compared with conventional group. The survival rate in the first week was 85. 8% with no statistical difference （P〉0. 05）. Conclusions The modified PBS cuff insertion technique for PV anastomoses of OLT has advantages in speed, safety and stabilization, and should be considered as one of the best available PV anastomosis technique for OLT in rats.