临床活体肝部分移植术胆道重建技巧及引流

Aim: To explore the techniques of reconstruc-tions and drainage of biliary tract in the clinical living relat-ed partial liver transplantation. Methods: Ten cases of patients received clinical living related partial liver transplantation were presented. The methods and traits of reconstructions and drainage of binary tract in the operation were introduced. Results: All of 10 cases were performed with lefthepatocholangiojejunostomy of Roux-Y, six of them wereinstalled with binary introudrain ducts, one with biliary ex-tro-drain duct, and the rest 3 cases without any drain ducts.The whole group recovered satisfactorily. Conclusion: Left-hepatocholangiojejunostomy of Roux-Yis the main methodof reconstructions of biliary duct in clinical living relatedpartial liver transplantation. The method of installing bil-iary extro-drain ducts may not be adopted by experiencedoperators.

临床活体肝部分移植10例的适应证及手术时机

目的：探讨肝部分移植的适应证及手术时机．方法：以９例先天性胆道闭锁症、１例暴发性肝炎患者为对象：全组病例均为儿童，年龄３月龄～１２岁，其中男３例，女７例，均处于不同程度的肝功能不全状态．结果：全部病例均在全麻下接受了源自患儿父亲或母亲的部分肝移植术，手术历时１０～１５ｈ，出血量１０００ｍｌ左右，无肝期９０～２１０ｍｉｎ，术后恢复良好，移植肝脏全部成活．结论：现阶段临床活体肝部分移植的适应证多为先天性胆道闭锁症，移植对象多为儿童，手术时机应根据患者的病史及肝功能状况确定，目前尚无统一明确的标准．但一旦确定了肝移植的方针后，则应尽早手术．

活体肝部分移植供体手术10例的围手术期处理体会

目的探讨临床活体肝部分移植供体手术的围手术期处理。方法作者分析10例供体的资料,其中包括在日留学期间亲自参与处理的9例和在我国开展的首例活体肝部分移植术的供体资料,从供体的选择原则、术前准备、供肝切取量的确定、供肝的切取及供体手术的术后处理和手术安全性等方面总结活体肝部分移植供体手术围手术期处理经验。结果 10例患者中男女各5例,均为受体的父亲或母亲,肝切取量在21%～29%,其中肝左外叶切取术9例,肝左叶切取术1例,全组病例在围手术期内未发生任何并发症,所提供的肝脏也全部存活。结论在良好的术前准备条件下.供体手术是安全的,其围手术期处理原则与常规肝切除术一致。