摘要
目的 探讨成人间活体肝移植供体右半肝切取的技术。方法 8例成人间活体肝移植行供体右半肝切取 ,供肝切取范围 :右半肝 5例、扩大右半肝 3例。供肝保留直径 0 .8cm以上的副右肝静脉。右半肝切除线在中肝静脉的右侧 0 .5～ 1.0cm处 ,扩大右半肝切除线在中肝静脉左侧 0 .5～1.0cm处。行术中胆道造影 ,在切取过程中不阻断入肝血流。结果 供体平均手术时间为 44 8(3 5 3～ 5 10 )min。供体手术平均失血量为 3 84(170～ 90 0 )ml。切取的移植物平均重 669.4(4 4 5～90 0 ) g ,其中右半肝移植物平均重 667.0g ,扩大右半肝移植物平均重 673 .3 g。移植物与受体体重之比平均为 1.16% (0 .76%～ 1.5 0 % )。供体术后发生胆漏、肝肾功能不全各 1例 ,经治疗后均痊愈。全组无手术死亡 ,均于 3周内恢复出院。 8例移植物和 8例受体的 1年生存率均为 10 0 %。结论 熟练掌握精良的供肝切取技术 ,成人活体肝移植中右半肝和扩大右半肝的切取对供体来说是安全的。
Objective To study the surgical technique of right hemihepatectomy in adult-to-adult living donor liver transplantation . Methods Eight donors underwent right hemihepatectomy in adult-to-adult living donor liver transplantation . Among these donors operation, there were 5 right hemihepatectomy and 3 extended right hemihepatectomy . If the diameter of the auxiliary right hepatic vein more than 0.8cm, it should be reserved. The dissection line of right hemihepatectomy was at the 0.5cm～1.0cm to the right side of middle hepatic vein, and the dissection line of extended right hemihepatectomy was at 0.5cm～1.0cm to the left side of middle hepatic vein. Intraoperative cholangiogram was performed, and without inflow vascular occlusion was done during the operation.Results The donor average operation time was 448 min (ranged from 353 min to 510 min). The average blood loss of operation was 384 ml (ranged from 170ml to 900ml). The grafts average weight was 669.4g (ranged from 445g to 900g), the right hemihepatic grafts weighted 667.0g averagely and the extended right hemihepatectic grafts weighted 673.3g averagely.The average graft-to-recipient body weight was 1.16% (ranged from 0.76% to 1.50% ). There were 2 donors occurred complications including biliary leak in 1, and dysfunction of liver and kidney in 1, all the 2 complications were cured. There was no donor mortality and all donors well recovered,All the donors were discharged within three weeks after operation.All of the 8 grafts and 8 recipients survived one year. Conclusions The right hemihepatectomy and extended right hemihepatectomy in adult-to-adult living donor liver transplantation can be performed safely,if the liver resection techmqne is proformed exactly and successfully.
出处
《中国普通外科杂志》
CAS
CSCD
2004年第3期212-215,共4页
China Journal of General Surgery
关键词
肝移植
成年人
肝移植/方法
LIVER TRANSPLANTATION
ADULT
LIVER TRANSPLANTATION/methods
