肝移植术中经供肝肝圆韧带入路介入治疗门静脉血栓3例  

Interventional treatment of portal vein thrombosis via hepatic circular ligament approach during liver transplantation:a report of 3 cases

作　　者：陈池义 王浩[2] 张骊[1] 郭庆军[1] 王洪海[1] 孙纪三[1] 陈光[2] 蒋文涛[1] Chen Chiyi;Wang Hao;Zhang Li;Guo Qingjun;Wang Honghai;Sun Jisan;Chen Guang;Jiang Wentao(Department of Liver Transplantation,Tianjin First Center Hospital,Tianjin Key Laboratory of Molecular and Treatment of Liver Cancer,Tianjin 300192,China;Department of Radiology,Tianjin First Center Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院肝移植科,天津市肝癌分子诊断与治疗重点实验室,天津300192 [2]天津市第一中心医院放射介入科,天津300192

出　　处：《中华器官移植杂志》2024年第11期811-814,共4页Chinese Journal of Organ Transplantation

基　　金：天津市卫生健康委员会重点学科专项(TJWJ2022XK016);天津市卫生健康委员会基金(TJWJ2022QN032)。

摘　　要：本研究报道了天津市第一中心医院3例肝移植术中经供肝肝圆韧带入路介入治疗门静脉血栓受者诊治情况,该3例受者肝移植术中行血栓切除后,因部分血栓残留引起狭窄导致移植肝血流不足,选择其它有效治疗方式风险大或技术困难。为尽快恢复血流,术中实施经供肝肝圆韧带入路介入治疗门静脉残留血栓,通过球囊扩张及血管支架植入有效解除局部狭窄。治疗后门静脉流速及流量达到标准,术后移植肝功能顺利恢复,随访支架通畅,无新增血栓形成。该术式是一种简单、安全、有效的治疗方法,且目前尚无文献报道。Three recipients with portal vein thrombosis experienced insufficient blood flow to transplanted liver due to residual thrombus after thrombectomy during liver transplantation.Alternative measures posed significant risks or technical challenges.To promptly restore blood flow,intraoperative intervention was performed via round ligament of donor liver for managing residual portal vein thrombus.Balloon dilation and vascular stenting effectively relieved local stenosis.After intervention,portal vein flow rate and volume fulfilled the standards and function of transplanted liver recovered smoothly.Follow-ups revealed unobstructed stents and no new thrombus formation.This simple,safe and efficacious technique has not been previously reported in the literature.

关 键 词：肝移植 门静脉血栓 肝圆韧带 介入治疗 手术入路 超声多普勒 

分 类 号：R657.3[医药卫生—外科学]