经典式原位肝移植术弃用静脉转流的经验总结

A Summary of the Experience of Classic Orthotopic Liver Transplantation without Venovenous Bypass

目的：观察经典式原位肝移植术不作静脉转流的效果，分析不转流对术后胃肠道及肾脏功能的影响。方法：总结自１９９９年来我所４５例经典式原位肝移植术弃用静脉转流的经验。结果：４５例术中无肝期时间平均为５４．５ｍｉｎ，术后与不转流相关的胃肠道和肾功能明显损害的并发症有４例：３例术后近期发生急性肾功能衰竭，２例经血透后恢复，１例死亡；另１例于术后１．５月发生急性坏死性胰腺炎。结论：若无肝期控制在１ｈ内，经典式原位肝移植不作转流，并不显著增加胃肠道和肾脏功能损害等并发症，且有缩短手术时间和节省费用等优点。

Objective:To observe the result of classic orthotopic liver transplantation (OLT) without venovenous bypass and its influence on the gastro-intestinal tract and renal functions. Methods:By summarizing the experience of 45 classic OLT without bypass since 1999 was summarized. Results:The mean anhepatic period time was 54.5 minutes. Four cases experienced serious postoperative complications pertinent to the non-usage of venovenous bypass during operation: Three had acute perioperative kidney failure and one suffered from acute necrotic pancreatitis 1.5 month postoperatively, two of whom died. Conclusions:Classic OLT without venovenous bypass can be successfully performed if the anhepatic period is controlled within one hour, which does not increase the rate of gastro-intestinal tract and nenal complications, and provides the advantage of saving time and money.