成人原位背驮式肝移植——附8例报告  

Piggyback orthotopic liver transplantation in adults-a clinical report of 8 cases

作　　者：莫一我[1] 傅德庄[1] 孙志为[1] 王彦坤[1] 刘玉明[1] 董坤[1] 唐建中[1] 金焰[1] 朱秀芳[1] 王晓云[1] 

机构地区：[1]云南省第一人民医院肝胆外科,650000

出　　处：《消化外科》2002年第5期365-367,共3页Journal of Digestive Surgery

摘　　要：目的 研究原位背驮式肝移植治疗终末期肝病的手术技巧及临床效果。方法 在23月内为8例终末期肝病病人实施原位肝移植手术,其中肝炎后肝硬化2例,肝癌1例,酒精性硬化1例,化疗后中毒性肝炎致肝硬化1例,原发件胆汁性肝硬化3例。结果 手术成功率100％,1例手术后32天死于肾功能衰竭,围手术期存活7例（87.5％）,随访期间7例病人均存活,现存活7例（87.5％）,生存时间最长1例已23个月。术后并发症:腹腔出血并肾衰竭1例;腹腔内出血胆瘘致腹膜炎1例。结论 肝移植手术是终末期肝病的有效治疗手段。在成人原位背驮式肝移植病肝切除术中,有效的预防减少出血及其它手术并发症,预防肝移植术后乙肝再感染,有效而合理的使用免疫抑制剂是提高手术成功率,保证长期生存的关键。Objective To study the operative technique and effects of piggyback orthotopic liver transplantation (POLT) on the results of treatment for end - stage liver diseases. Methods 8 patients with the end - stage liver diseases were treated with (PILT) in our department from August 2000 to April 2002. Of the patients, 2 patients had HBV related cirrhosis, 1 cirrhosis with liver cancer, 1 alcoholic cirrhosis, 1 cirrhosis resulting from toxic hepatitis, and 3 primary biliary cirrhosis. Results The successful rate ol the operation was 100% . 1 died of renal failure on postoperation day 32. 7 patients were still alive in the perioperalive period (87.5%). Of the left 7 patients: 1 patient with alcoholic cirrhosis has survived for 23 months. Of the 8 patients, 2 patients was re - explored because of bleeding in abdominal cavity on day 5 and day 12 after operation and 1 patient was re - explored because of bile leak. Conclusions The liver transplantation is an effective method in treatment of end- stage liver diseases. To prevent and reduce blood loss during the course of the resection of the diseases and the incidence of other operative complications as well as the reinfection of HBV alter operation and use immunosuppressive drugs effectively are the key factors for promoting successful rate of the operation and increasing survival time of the patients.

关 键 词：肝炎后肝硬化 背驮式肝移植 终末期肝病 

分 类 号：R657.3[医药卫生—外科学]