Aucejo Federico, Winans Charles, Henderson J Michael, Vogt David, Eghtesad Bijan, Fung John J, Sands Mark, Miller Charles M
Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Liver Transpl. 2006 May;12(5):808-12. doi: 10.1002/lt.20747.
The "piggyback" technique for liver transplantation has gained worldwide acceptance. Still, complications such as outflow obstruction have been observed, usually attributable to technical errors such as small-caliber anastomosis of the suprahepatic vena cava, twisting, or kinking. Iatrogenic Budd-Chiari syndrome after piggyback liver transplantation has been reported as a consequence of obstruction involving the entire anastomosis (usually the 3 hepatic veins). Here we describe technical issues, clinical presentation, diagnosis, and treatment of 3 cases in which outflow obstruction affected only the right hepatic vein. In conclusion, all 3 patients developed recurrent ascites requiring angioplasty and/or stent placement across the right hepatic vein to alleviate the symptoms.
肝移植的“背驮式”技术已获得全球认可。尽管如此，仍观察到诸如流出道梗阻等并发症，通常归因于技术失误，如肝上下腔静脉小口径吻合、扭曲或扭结。据报道，背驮式肝移植术后医源性布加综合征是整个吻合口（通常是3条肝静脉）梗阻的结果。在此，我们描述了3例流出道梗阻仅累及右肝静脉的技术问题、临床表现、诊断及治疗。总之，所有3例患者均出现复发性腹水，需要进行血管成形术和/或在右肝静脉置入支架以缓解症状。
