摘要
肝移植受体并门静脉栓塞原因通常分为门静脉血栓(PVT)和门静脉癌栓(PVTT)。术前准确诊断评价门静脉系统,对鉴别门静脉栓子性质及肝移植手术方式指导意义重大。本文对当前合并门静脉栓塞肝移植受体的术前诊断方法及伴PVT肝移植术中重建门静脉的术式进展作一简要综述。
Portal vein thrombosis （PVT） and portal vein tumor thrombosis （PVTT） are common eontraindications for liver transplantation. While portal vein embolization has shown remarkable success in managing both contraindications, hepatocellular carcinoma - a frequent cause of PVTT - remains an absolute contraindication for liver transplantation. Therefore, it is not only crucial to diagnose PVT or PVTT pre- operatively but also to determine the underlying etiology of the complication. This article summarizes the known etiologies and the various classification and grading systems of PVT, as well as the features and benefits of the established preoperative diagnostic methods for PVT and PVTP, including color Doppler ultrasound, computed tomography （CT） , magnetic resonance imaging, digital subtraction angiography, and positron emission tomography - CT. Finally, the various management procedures available for treatment of PVT, including venous thrombec- tomy, vein bypass/interposition grafting, vein arterialization, cavoportal hemitransposition, and liver/small bowel co -transplantation, are discussed along with published results of patient outcome and limitations yet to be overcome. Obtaining a comprehensive evaluation and accu- rate preoperative diagnosis of the portal venous system, and having an understanding of the various surgical approaches for managing PVT, will promote the chances of successful patient outcome.
出处
《临床肝胆病杂志》
CAS
2013年第4期314-318,共5页
Journal of Clinical Hepatology
关键词
静脉血栓栓塞
门静脉
肝移植
vein thrombolism
portal vein
fiver transplantation
