Variations of surgical reconstruction in liver transplantation depending on vasculature
Variations of surgical reconstruction in liver transplantation depending on vasculature
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肝移植手术重建的变化取决于血管系统
DOI：
10.1007/s004230050217
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Peter Neuhaus
中科院分区：
文献类型：
--
作者：
U. Settmacher;R. Haase;M. Heise;W. Bechstein;Peter Neuhaus
背景：从1988年9月至1998年4月，911例患者接受了1000例肝移植。由于器官受体血管系统的异常解剖特征和病理变化，19%的动脉侧病例和5.6%的门静脉侧病例修改了用于保证移植期间最佳血液流入的肝脏血运重建标准技术。肝左动脉12支，肝右动脉101支，均成功重建，无并发症。我们认为，术前诊断血管（腹腔干狭窄等）因此，通过超声和血管造影对器官受者进行检查是必要的。即使在这些检查的帮助下，诊断脾动脉“盗血”综合征也极其困难：例如，40名肝功能不佳的患者中有31人因新诊断的“盗血”接受了术后治疗。结果和结论：并发症没有增加（狭窄和血栓形成）与动脉重建的修改（4.9比6.3%）;然而，与门静脉重建的修改是从2.4%增加到8.3%。
Background: From September 1988 through April 1998, 1000 liver transplantations were performed on 911 patients. The standard technique for liver re-vascularization to guarantee an optimal blood inflow during transplantation was modified in 19% of the cases on the arterial side and in 5.6% of the cases on the portal side as a result of unusual anatomical features and pathological changes in the vasculature of the organ recipient.In 113 transplantations, successful reconstruction of accessory vessels of the graft (12 left and 101 right hepatic arteries) was performed without complications. It is our opinion that preoperative diagnosis of the vasculature (stenoses of the celiac trunk etc.) of the organ recipient by duplexsonography and angiography is necessary. Even with the help of these tests, it is extremely difficult to diagnose a ”steal” syndrome in the splenic artery: for example, 31 of 40 patients with poor liver function received postoperative therapy for newly diagnosed ”steals”.Results and conclusions: There is no increase in complications (stenosis and thrombosis) with modifications of arterial reconstruction (4.9 vs 6.3%); however, with modification of portal reconstruction the increase is from 2.4% to 8.3%.