摘要
目的探讨活体肝移植(LDLT)中胆道重建技术及并发症处理原则,减少胆道并发症的发生.方法回顾性分析活体肝移植18例,其中右半肝11例,左半肝10例,双供体(右半肝+左半肝)3例,胆道重建采用显微外科技术.17例行胆管-胆管端端吻合,1例行肝管空肠吻合.结果术后3例受体发生了胆道并发症.2例为成人右半肝移植,1例于术后2d发现胆漏,经保守治疗无效,再次开腹改行肝管空肠吻合后治愈;1例术后3月发现胆管轻度狭窄,行保守治疗治愈.1例为双供体置入T管者,术后第3天发现胆漏,行保守治疗后治愈.结论在活体肝移植中采用显微外科技术,适当整形胆管行胆管-胆管端端吻合,有助于降低术后胆道并发症的发生.
Objective To explore the techniques of biliary reconstruction and the managing principles of biliary complications in living donor liver transplantation （LDLT） so as to reduce the incidence of post-operative biliary complications. Methods The clinical data of 18 patients underwent LDLT （11 for right lobe, 10 for left lobe, and 3 dual grafts） were analyzed retrospectively. The microsurgical techniques were used to reconstruct biliary tract which the duct-to-duct anastomosis for 17 cases and hepato-jejunostomy for one case. Results Post-operative biliary complications occurred in 3 patients. One patient who underwent duct-to-duct anastomosis suffered from leakage from the anastomotic stoma 2 days after operation and hepato-jejunostomy was performed to repair the leakage and carry out drainage after inefficiency of conservative treatment. Mild stricture of the anastomotic stoma occurred in the other patient 3 months after operation and conservative treatment was given. Both patients recovered. Conclusion Introduction of microvascular surgery and duct-to-duct anastomosis with shaping of bile ducts to biliary reconstruction in LDLT, can reduce the incidence of post-operative complications.
出处
《昆明医学院学报》
2009年第7期100-103,共4页
Journal of Kunming Medical College
关键词
肝移植
活体
胆道重建
显微外科
胆道并发症
Liver transplantation
Living donor
Biliary reconstruction
Microsurgery
Biliary complic - ation
