供胰的切取保存及修整技术

Technology of excision, preservation and finishing on donative pancreas

目的 :探讨胰肾联合移植术的供体器官切取、保存及修整的技术方法。方法 :1998年 5月～2 0 0 3年 9月共联合整块切取腹部多器官 86例次 ,期间施行 2例改良式胰液空肠引流胰十二指肠及肾一期联合移植术 ,结合我院联合整块切取腹部多器官的经验 ,及胰肾联合移植临床开展情况对供胰的切取与修整技术进行总结。结果 :联合整块切取腹部多器官 86例均成功 ,热缺血时间在 3min之内。施行 2例改良式胰液空肠引流胰十二指肠及肾一期联合移植术 ,术后移植胰、肾功能均恢复正常 ,无其它外科并发症。结论 :掌握正确的供胰切取、保存及修整方法是保证移植成功的关键因素 ,主要包括供胰切取的速度与质量以及修整过程中的一些注意点 ,以尽量缩短热缺血时间 。

Objective: To explore the technology of excision, preservation and finishing on donative pancreas during for combined pancreas-kidney transplantation. Methods: We successfully harvested multiple abdominal organs together on 86 cases during May 1998 to September 2003, including SKPT with enteric drainage of exocrine was performed on 2 patients with insulin-dependent diabetes mellitus/end-stage renal disease. Results: Excisions of donative abdominal organ were successful in all 86 cases. The warm ischermic time was no more than 3 minutes. The 2 cases of combined pancreas-kidney transplantation became insulin-independent after they had been treated by small dose insulin for 5～10 days. Conclusion: Technology of excision, preservation and finishing on donative pancreas for combined pancreas-kidney transplantation was one of the key points for successful transplantation, which include: fast excision and finishing during operation and shorten the warm ischermic time and avoid injury.