背驮式肝移植肝脏流出道的重建经验

EXPERIENCE OF HEPATIC OUTFLOW TRACT RECONSTRUCTION IN PIGGYBACK

目的 总结西南医院背驮式肝移植时肝流出道重建的经验。方法 回顾性分析收治的 67例背驮式肝移植时肝流出道重建的方法改进及效果。结果 肝移植病例围手术期死亡 7例 ,手术死亡率为 10 45 %。并发症 :肺部感染 3 8例 ,多器官功能衰竭 10例 ,腹腔内出血 6例 ,ARDS 14例 ,肝动脉血栓形成 1例 ,胆漏 1例 ,无肝脏流出道梗阻。 2例存活超过 3年 ,8例存活超过 2年 ,19例存活超过 1年。结论 肝流出道重建方法的改进有利于提高背驮式肝移植的成功率 ,减少技术性并发症。

Objective: To summarize the experience of hepatic outflow tract reconstructon in piggyback liver transplantation .Methods: The clinical data of 67 cases of piggyback liver transplantation were analyzed retrospectively from Jan, 1999 to Oct, 2002.Results: Seven patients died perioperatively. The mortality rate of this group was 10 45%.Complications:Pulmonary infection (38 cases),MOSF (10 cases),intraperitoneal bleeding (6 cases),ARDS (14 cases), thrombus of hepatic artery (1 case), bile leakage (1 case), no hepatic outflow tract occlusion.Survival time:more than 3 years (2 cases),more than 2 years (8 cases), more than 1 year (19 cases).Conclusions: The innovation of hepatic outflow reconstructon in piggyback liver transplantation is advantageous for the increase of success rate and decrease of technical complications.