非整块肝脏和小肠联合移植的外科技术(附一例报告)  

Surgical techniques for combined noncomposite liver and small bowel transplantation: the first case in China

作　　者：李幼生[1] 李宁[1] 李元新[1] 倪小冬[1] 朱亮[1] 曹斌[1] 李为苏[1] 罗开[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院全军普通外科研究所,210002

出　　处：《中华器官移植杂志》2005年第2期108-110,共3页Chinese Journal of Organ Transplantation

摘　　要：　目的　介绍国内首例非整块肝脏和小肠联合移植的外科技术。方法　采用在体灌注、整块切取的方法获取肝脏和小肠,供者器官采用 UW液保存。将供者肝脏、小肠联合植入短肠综合征合并胆汁淤积的男性受者体内,供肝采用改良背驮式肝移植术;供肠的动脉、静脉分别与受者的肾下腹主动脉和下腔静脉吻合。结果　至术后2个月时,移植小肠和肝脏均无排斥反应,肠黏膜结构正常,对肠内营养耐受良好;CT示移植肝形态正常,复查肝功能完全恢复正常。结论　选择性应用非整块肝脏和小肠联合移植术是安全有效的,特别适合需要接受肝脏、小肠联合移植的成年患者。Objective To introduce the surgical techniques for combined noncomposite liver and small bowel transplantation of the first case in China. Methods The donor was perfused in situ and the grafts including intestine, liver, pancreas and kidneys were procured en bloc. The grafts were preserved with UW solution. The combined noncomposite liver and small bowel was transplanted into a patient with short gut syndrome complicated with liver cholestasis. The SMA and portal vein of intestinal graft was anastomsed to end to side. The liver graft was placed according to the method of modified piggyback fashion. Results No rejection occurred in intestinal and hepatic grafts in 2 months after operation. The mucosal structure of intestinal graft was normal, and the intestinal graft could tolerance enteral nutrition well. The liver morphology and function were normal. Conclusion The combined noncomposite liver and small bowel transplantation was recommended for selective adult patients requiring both intestinal and liver transplantations.

关 键 词：非整块肝脏 小肠 联合移植 外科技术 

分 类 号：R617[医药卫生—外科学]