Hepatic artery reconstruction and biliary stricture formation after living donor adult liver transplantation using the left lobe
Hepatic artery reconstruction and biliary stricture formation after living donor adult liver transplantation using the left lobe
复制标题
活体成人左叶肝移植术后肝动脉重建及胆道狭窄形成
DOI：
10.1053/jlts.2002.32986
复制
发表时间：
2002
影响因子：
4.6
通讯作者：
K. Sugimachi
中科院分区：
文献类型：
--
作者：
T. Suehiro;M. Ninomiya;S. Shiotani;Syoji Hiroshige;N. Harada;Minagawa Ryosuke;Y. Soejima;M. Shimada;K. Sugimachi
胆道并发症，包括胆漏，胆管狭窄和胆管炎，在活体肝移植后的所有病例中占15%至29%。我们研究了风险因素，并讨论了使用左叶移植物的成人活体肝移植术后胆道并发症的管理。我们研究了37例使用左叶移植物进行活体肝移植的成人患者。将围手术期变量作为胆道狭窄的风险因素进行评价。胆道并发症的总发生率为43.2%（16/37例患者）。吻合口狭窄8例，胆漏9例，胆管炎8例。吻合口狭窄与部分动脉重建（P <0.02）和胆管炎（P <0.01）密切相关。吻合口胆管狭窄与胆漏、急性细胞排斥反应或感染无关。我们的研究结果表明，胆道吻合口狭窄的一个重要危险因素是部分动脉重建。为了尽量减少胆道吻合口狭窄的风险，我们将重建肝中动脉和肝左动脉。
Biliary complications, including bile leak, biliary stricture, and cholangitis, are seen in 15% to 29% of all cases after living related liver transplantation. We investigate risk factors and discuss the management of biliary complications after living related liver transplantation in adults using left‐lobe grafts. We studied 37 adult patients who underwent living related liver transplantation using left‐lobe grafts. Perioperative variables were evaluated as risk factors for biliary strictures. The overall incidence of biliary complications was 43.2% (16 of 37 patients). Anastomotic strictures occurred in 8 patients, whereas bile leaks and cholangitis occurred in 9 and 8 patients, respectively. Anastomotic stricture was strongly related to a partial artery reconstruction (P < .02) and cholangitis (P < .01). Anastomotic biliary stricture was not associated with bile leak, acute cellular rejection, or infection. Our results suggest that an important risk factor for biliary anastomotic biliary strictures is a partial artery reconstruction. To minimize the risk for biliary anastomotic strictures, we will reconstruct both the middle and left hepatic artery.