40例临床肝移植血管和胆管重建经验

Experience of vascular and bile duct reconstruction in 40 cases of orthotopic liver transplantation

目的 总结第三军医大学西南医院肝移植时血管及胆管重建的经验。方法 回顾性分析４０％肝移植时血管重建、胆道重建的方法及效果。结果 本研究肝移植病例围手术期死亡６例，手术病死率为１５．０％。并发症为：肺部感染１８例；多器官功能衰竭５例；腹腔内出血４例；ＡＲＤＳ ８例；肝动脉血栓形成１例；胆漏１例；脑出血１例。存活最长的１例为３１个月，有１５例生存期超过１年。结论 良好的血管和胆管重建技术是确保肝移植手术成功的关键。

Objective To summarize the vascular and bile duct reconstruction experience in 40 cases of orthotopic liver transplantation in the southwest hepatobiliary surgery hospital. Methods The clinical data of 40 cases of liver transplantation were analyzed retrospectively from Jan. 1999 to Nov. 2001. Results Mortality rate of this group was 15.0%. Complications included: pulmonary infection (18 cases), MOSF (5 cases), intraperitoneal bleeding (4 cases), ARDS (8 cases), thrombus of hepatic artery (1 case), bile leakage (1 case), and cerebral hemorrhage (1 case). The longest survival time was 31 moths (1 case). There were 15 cases whose survival time was more than 1 year. Conclusions The key point of success of liver transplantation relies on excellent vascular and bile duct reconstruction technique.