改良背驮式肝移植69例报告

The modifying piggyback liver transplantation:report of 69 cases.

目的 介绍一种新的肝移植术式 -改良背驮式肝移植术 (腔静脉整形 )。方法 对 2 0 0 0年 6月至2 0 0 2年 4月期间采用改良背驮式肝移植 (腔静脉整形 )技术完成的 69次肝移植术的临床资料进行总结 ,并与同期采用经典原位肝移植技术完成的 3 2例肝移植病人资料进行对比。结果 改良背驮式肝移植组和经典原位肝移植组无肝期时间分别为 (4 2 1± 12 4)min和 (71± 18)min(P <0 0 5 ) ;失血量分别为 (2 40 0± 115 0 )mL和 (5 3 0 0± 2 10 0 )mL(P <0 0 5 ) ;输血量分别为 (2 80 0± 13 0 0 )mL和 (5 40 0± 190 0 )mL(P <0 0 5 ) ;术后 1天腹腔引流量分别为 (3 72± 89)mL和 (12 66± 43 8)mL(P <0 0 5 ) ;前者无腔静脉并发症发生 ,后者发生腔静脉并发症 9例。结论 改良背驮式肝移植术能明显简化切肝、植肝手术操作 ,显著缩短无肝期时间、减少出血、输血量以及腔静脉并发症 ,优于经典的原位肝移植术和背驮式肝移植术 。

Objective To introduce a new liver transplantation technique:modifying piggyback(PB) technique(cavaplasty).Methods To Compare 69 cases of liver transplantation by modifying PB technique(cavaplasty) with 32 cases of liver transplantation by standard liver transplantation(OLT) between June,2000 and Apr,2002.Results Results of modifying PB(cavaplasty) group and standard OLT group were as follows:anhepatic phase:(42 1±12 4)min and (71±18)min (P<0 05) ;Blood loss:(2400±1150)mL and (5300±2100)mL(P<0 05);Blood transfusion:(2800±1300)mL and (5400±1900)mL(P<0 05);Total drainage within 1 day after transplantation:(372±89)mL and(1266±438)mL(P<0 05);No vena cava complication occurred in modifying PB(cavaplasty) group,but 9 cases in standard OLT group.Conclusion The modifying PB(cavaplasty) technique can make the hepatectomy and implantation of donor liver much easier.It reduces anhepatic phase,blood loss,blood transfusion and the incidence of vena cava complications significantly.Modifying PB(cavaplasty) technique can be used in all kinds of liver transplantation.