摘要
目的 探讨原位肝移植的适应证、手术技术及围手术期处理特点。方法 对 1例肝尾叶癌 ,2例先天性弥漫性肝内胆管囊性扩张症及 7例晚期肝硬变患者进行了原位肝移植 ,对其中 1例 11岁女孩进行了减体积肝移植(RSLT)。供肝均取自 2 0～ 40岁脑死亡的健康人。 8例供、受者ABO血型相同 ,2例供者为O型 ,受者为A型。供肝采用单独肝脏切取法 ,以UW液进行门静脉和腹主动脉灌注。病肝采用经典式原位肝移植切肝法 ,在生物泵转流下切除病肝。植肝采用肝上下腔静脉、肝下下腔静脉、门静脉、肝动脉及胆管顺序。结果 10例患者移植肝活力恢复良好 ,无手术死亡。 1例肝尾叶癌于术后 139天因肿瘤复发死亡 ,1例死于严重全身霉菌感染 ,1例死于应激性溃疡穿孔 ,另 7例存活良好 ,无并发症。结论 不能切除的中央型肝癌、终末期良性肝病及终末期肝硬变是肝移植的良好适应证 。
Objective To Investigate the indications, surgical technique and perioperative management of orthotopic liver transplantation. [WT5”HZ]Methods [WT5”BZ]Orthotopic liver transplantation was successfully performed on a unresectable liver cancer on caudate lobe, 2 cases with Caroli’s disease and 7 cases with advanced liver cirrohosis. A 11 year’s old girl with Caroli’s disease was performed on one reduced size liver transplantation (RSLT). [WT5”HZ]Results [WT5”BZ]The recovery of liver graft function was good after the operation in those patients without perioperative death. The case of liver cancer died of recurrent cancer on the 139th postoperative day, 1 case died of severe fungus infection and one died of gastric stress ulcer perforation, other 7 cases recovered well without complications. [WT5”HZ]Conclusion [WT5”BZ]The results suggest that unresectable central liver cancer, terminal liver cirrohosis or benign liver diseases combined with severe liver disfunction are good indications for liver transplantation. Good surgical technique and perioperative management are key points to succucess of the liver transplantation.
出处
《中国普外基础与临床杂志》
CAS
2000年第4期231-234,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
原位肝移植
同种异体移植
肝肿瘤
肝硬化
Liver transplantation
Reduced size transplantation
Liver cancer
Liver cirrohosis
