50例次背驮式肝移植技术回顾分析  

The retrospective study on 50 cases of piggyback liver transplantations

作　　者：叶启发[1] 陈知水[1] 曾凡军[1] 林正斌[1] 夏穗生[1] 刘敦贵[1] 陈实[1] 张伟杰[1] 文志向[1] 沙波[1] 刘慎薇[1] 宫念樵[1] 蒋继贫[1] 李岗山[1] 薛德麟[1] 裘法祖[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《中华器官移植杂志》2001年第5期282-284,共3页Chinese Journal of Organ Transplantation

摘　　要：目的　总结背驮式肝移植术的经验 ,力求进一步完善经典式背驮式肝移植技术。方法　 5 0例次背驮式肝移植中 ,17例次采用经典式背驮式肝移植 (SPBLT) ,2 4例次采用改良式背驮式肝移植 (APBLT ,供、受者的下腔静脉行端侧吻合或侧侧吻合 ) ,其它肝移植术式的改良 9例次。结果　17例次经典式背驮式肝移植均存在供、受者血管口径不匹配、供肝放置棘手、血管重建后肝静脉回流道易扭曲及压迫重建的回流血管等问题 ;而改良式背驮式肝移植中 ,下腔静脉与下腔静脉行端侧吻合者仍存在不同程度的上述缺陷 ,而侧侧吻合术式则可完全改善经典式背驮式肝移植的技术并发症。结论　改良式背驮式肝移植修正了经典式背驮式肝移植存在的技术缺陷 ,减少了技术并发症。Objective To perfect the techniques of piggyback liver transplantation (PBLT) by retrosspectively analyzing the clinical data of 50 case times receiving PBLT. Methods From 1995, 47 patients with end stage liver diseases underwent 50 times of PBLT (including 3 cases of piggyback liver retransplantation, PBLRT). Among the 50 case times of PBLT, 17 were standard PBLT (SPBLT), 24 ameliorated PBLT (APBLT), and 9 related APBLT. Results There existed the disadvantage of mismatch between the blood vessels of the donor and the recipient, difficulty of putting the donor's liver and twisting and pressing of the reconstructed veins in the 17 cases of the SPBLTx. But the so called APBLTx that was done by the end to side anastomosis (ESAT) of the donor's inferior vena cava (IVC) to the recipient's also had the above mentioned disadvantage to some extent. The technique complications were decreased by the side to side anastomosis (SSAT). And the other 9 related APBLT widened the range of the indications of the liver transplantation. Conclusions The different ideas about the technique of SPBLT need to be further discussed. The APBLT and the related APBLTx disolved the disadvantage existing in the SPBLT, by decreasing the technique complications on one hand and widening the range of the indications of liver transplantation on the other hand.

关 键 词：肝移植 外科手术 综合分析 背驮式肝移植 受者 术后生存 

分 类 号：R657.3[医药卫生—外科学]