重建肝动脉血供大鼠原位肝移植模型的术式探讨

Studies on the ways of orthotopic liver transplantation with hepatic artery anastomoses in rats

目的 探讨重建肝动脉血供的大鼠原位肝移植 (OLT)模型的手术操作方法 ,并对几种术式的效果进行了比较。方法 采用重建肝动脉血供的大鼠原位肝移植 60例 ,其中动脉“袖管式微血管缝合法”2 0例 ,动脉“套管法”2 0例和动脉“支架法”2 0例。同期行不吻合肝动脉的经典“二袖套法”96例。结果 各组手术时间 (包括供体手术 ) :“袖管式缝合法”(118.3± 12 .9)min ,“套管法”(10 6.2± 11.6)min ,“支架法”(93 .8± 10 .2 )min ,经典“二袖套法”(88.2± 9.6)min。无肝期均控制在 (2 0 .0± 2 .5 )min。经典“二袖套法”大鼠 1周存活率为 86.5 % (83 /96) ,重建肝动脉血供的大鼠 1周存活率为 86.7% (5 2 /60 )。胆道并发症发生率分别为 17.7% (17/96)和 6.7% (4 /60 )。结论 肝动脉重建的OLT本身并不能延长肝移植大鼠的生存时间 ,而肝动脉重建后可以减少术后胆道并发症的发生率。

Objective To investigate the surgical procedures of vascular anastomosis for rearterialization in orthotopic liver transplantation (OLTx) in rats and comparatively study the value of hepatic artery reconstruction in rat OLTx.Methods OLTx with rearterialization was conducted in 60 rats,including 20 arterial microvascular sleeve anatomosis,20 arterial cuff anastomosis and 20 arterial stent anastomosis.During the same period,96 rats were subjected to the classic two-cuff technique without rearterialization.Results Operative durations were shown as follows:arterial microvascular sleeve anatomosis (118.3±12.9) min,arterial cuff anastomosis (106.2±11.6) min,arterial stent anastomosis (93.8±10.2) min,classic two-cuff technique (88.2±9.6) min respectively.Anhepatic time in each group was (20.0±2.5) min.One-week survival rate in classic two-cuff technique group was 86.5% (83/96), 86.7% in groups with rearterialization (52/60).Incidence of biliary complications was 17.7% (17/96) and 6.7% (4/60) respectively.Conclusion OLTx with rearterialization can not improve the survival situation,but it does reduce the incidence of biliary complications.