原位肝移植前的肝动脉重建。

Hepatic artery reconstruction prior to orthotopic liver transplantation.

作者信息

Hevelke P, Grodzicki M, Nyckowski P, Zieniewicz K, Patkowski W, Alsharabi A, Paczek L, Krawczyk M

机构信息

Department of General, Transplantation, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.

出版信息

Transplant Proc. 2003 Sep;35(6):2253-5. doi: 10.1016/s0041-1345(03)00796-6.

DOI:10.1016/s0041-1345(03)00796-6

PMID:14529905

Abstract

BACKGROUND

This study examines the types of arterial reconstruction for grafts prepared for orthotopic transplantation procedures.

METHODS

Between 1993 and February 2003, 200 organs were harvested for orthotopic liver transplantation. Arterial variations were found in 28 cases (14%), among which 16 cases (8%) required vascular reconstruction with 4 cases due to accidentally damaged during liver harvesting.

RESULTS

Among the 200 organs harvested for liver transplantation, arterial variations requiring reconstruction were found in 12 cases (6%); these included: replacing an accessory left hepatic artery from the left gastric artery (9/1 reconstruction); replacing an accessory left hepatic artery from the upper mesenteric artery (2/1 reconstruction), and replacing an accessory right hepatic artery from the upper mesenteric artery (10/10 reconstructions). The splenic artery was typically used for anastomosis (seven cases, 58.3%) as well as the gastroduodenal artery (two cases, 16.7%) or the right gastric artery (one case, 8.3%). In the remaining two cases, a more complex technique was required.

CONCLUSIONS

Reconstruction of graft vessels before an orthotopic liver transplantation procedure does not increase the risk of vascular complications.

摘要

背景

本研究探讨了原位移植手术中供肝动脉重建的类型。

方法

1993年至2003年2月期间，共获取200个供肝用于原位肝移植。发现28例（14%）存在动脉变异，其中16例（8%）需要进行血管重建，4例是由于在切取肝脏时意外受损。

结果

在200个获取的肝移植供肝中，发现12例（6%）存在需要重建的动脉变异；这些变异包括：用胃左动脉替代副左肝动脉（9例，9/1重建）；用上肠系膜动脉替代副左肝动脉（2例，2/1重建），以及用上肠系膜动脉替代副右肝动脉（10例，10/10重建）。脾动脉通常用于吻合（7例，58.3%），胃十二指肠动脉（2例，16.7%）或胃右动脉（1例，8.3%）也用于吻合。其余2例需要采用更复杂的技术。