摘要
目的:探讨活体肝移植术前肝动脉评估、术中切取及吻合方式和术后处理方法.方法:回顾性分析活体肝移植患者2例的肝动脉处理方法,通过术前CT血管造影术(CTA)评估供受体肝动脉走形,拟定术中肝动脉的切取方式及吻合方法,探讨移植术后预防肝动脉并发症的方法.结果:CTA是术前评估供受体血管简单有效的方法.肝动脉有变异或动脉内径非常细的情况下,将受体一段动脉完整游离切除在后台和供体肝动脉在高倍显微镜下吻合,可提高动脉吻合质量.术后超声检查的精确性受上腹部气体影响明显时,CTA检查可明确吻合肝动脉的流通状况.术后应及早使用抗凝治疗,及时准确调整全身凝血功能,防止肝动脉栓塞.结论:术前正确的评估和高质量的动脉吻合以及术后适当抗凝治疗是预防术后肝动脉并发症的有效措施.
AIM： To explore the management of hepatic arterial variants in living donor liver transplantation. METHODS： A retrospective analysis was made in management of hepatic arterial variants in two cases of living donor liver transplantations. The experience of management was summarized up in the study. RESULTS： CTA was a simple but effective ap- proach to evaluating the hepatic artery before operation. Under the circumstance of hepatic arterial variants or quite small artery diameter, the quality of artery anastomosis could be strengthened through fully removing a piece of hepatic artery and anastomosis was conducted with hepatic artery from liver donor under powerful microscope. CTA was beneficial to describe the situation of hepatic artery in the case of poor results detected with ultrasound due to postoperative epigastric distension. Hepatic artery throm-bosis should be avoided if anti-coagulation was well prepared pre-operatively. CONCLUSION： Pre-operative valuation of hepatic artery, the highly qualified anastomosis and anticoagulation are important factors in prevention of postoperative hepatic arterial complications.
出处
《世界华人消化杂志》
CAS
北大核心
2009年第14期1471-1473,共3页
World Chinese Journal of Digestology
关键词
亲体肝移植
肝动脉变异
肝动脉栓塞
并发症
CT血管造影术
Liver transplantation
Hepatic arterial variants
Hepatic artery thrombosis
Postoperative complications
Computer tomographic angiography
