论经典背驮式肝移植技术

Piggyback technique of orthotopic liver transplant

经典背驮式肝移植术（PB-OLT）是一项成熟的原位肝脏移植技术.与经典原位肝移植术（ST-OLT）相比,背驮式肝移植术避免了术中对肝后下腔静脉的阻断,无需术中临时性门腔静脉分流（portocaval shunting）及体外转流术.该法节省了手术时间,减轻了术中血流动力学的改变,改善了术后移植肝恢复状况.本文分析肝静脉解剖变异与经典背驮式肝移植术式选择的关系.术中选择合适的肝静脉吻合方式可以减少术后流出道梗阻、血栓形成、稳固性腹水及其他并发症的发生,提高肝移植术后患者生存率,改善肝移植的预后.本文提出了背驮式肝移植术的术式参考标准.

Piggyback liver transplant technique is a mature orthotopic liver transplantation （PB-OLT）.Compared to the standard technique of orthotopic liver transplant （ST-OLT）,Piggyback liver transplant technique could avoid the dissection of retrohepatic vena cava,the use of venovenous bypass （VVBP）,and the temporary portocaval shunt.This method could shorten the operation time,maintain the hemodynamic stability,and improve the prognosis.This article analyzes the relationship between the anatomic variation of the hepatic vein and the Piggyback liver transplant method.The proper function of the hepatic vein anastomosis could mitigate the venous outflow obstruction,thrombosis and refractory ascites,or other postoperative complications.Therefore,this article designs the standardization for the Piggyback liver transplant technique.