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改良式供肝获取在原位肝移植中的临床应用

The Clinical Application of the Mended Method of Doner Hepatectomy in Orthotopic Liver Transplantation

【Author in Chinese】 李春友丁维宝李森庄冠一

【Author】 LI Chun-you,DING Wei-bao,LI Sen,ZHUANG Guan-yi (Department of Hepatobiliary Surgery,Weifang People’s Hospital,the Affiliated Hospital of Weifang Medical College,Weifang 261041,China)

【Institution】 潍坊医学院附属潍坊市人民医院肝胆外科潍坊医学院附属潍坊市人民医院肝胆外科 山东潍坊261041山东潍坊261041

【Abstract in Chinese】 目的介绍改良式供肝获取的方法及经验,完善供肝获取技术,提高供肝质量。方法自1999年1月~2006年8月共在35例次新鲜尸体上采用改进的方法获取供肝,其中26例次为模拟实验,灌洗液全部应用0~4℃乳酸林格氏液。5例次实施背驮式肝移植术,4例次实施经典式肝移植术。腹主动脉插管灌洗后,立即结扎肠系膜上血管,减少灌洗液的分流;根据不同时限调整门静脉灌注UW液的速度,延长灌注时间;修肝过程中再缓慢灌注0~4℃UW液1000ml。结果35例次所获取的供肝均颜色苍白,质地柔软,各种管道均满足手术吻合需要。热缺血时间为5~8min。9例肝移植病人无手术死亡,供肝功能发挥良好,节约UW液用量约1000ml。结论供肝获取的改良式方法较常用的经典式方法有明显优越性。

【Abstract】 Objective To introduce the mended method of donor hepatectomy in orthotopic liver transplantation.Methods From Jan 1999 to Aug 2006,mended methods of donor hepatectomy were performed on 35 cases fresh cadavers(19~43),males),26 simulant operations,5 piggyback fashion liver transplantations,4 classic fashion liver transplantations.In the simulant operations,the donor grafts were perfused with lactated Ringers solution at 0~4℃,in the 9 orthotopic liver transplantation,the liver grafts were perfused with UW solution at 0~4℃ via abdominal aorta and portal vein cannula,the superior mesentery vessels were ligatured to reduce diffluence and the perfusion speed was adjusted at variant time limit for the purpose of rapid temperature drop and enough perfusion for the grafts.Results All the procured grafts appeared paleness and soft texture and meet the require for anastomosis,the warm ischemia time was 5~8min,there was no operation death in the 9 patients with liver transplantation,and the function of the grafts was well,the portal vein perfusion reduced 1000ml UW solution each case.Conclusion The mended methods of the procuring of donor livers was superior to the classic method.

【Keywords in Chinese】 供肝肝移植灌注
【Key words】 Donor hepatectomyliver transplantationPerfusion
  • 【Source】 潍坊医学院学报 ,Acta Academiae Medicinae Weifang , Editorial E-mail ,2007(03)
  • 【CLC code】R657.3
  • 【Downloads】21
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