Wente Moritz N, Thorn Matthias, Radeleff Boris, Dei-Anane Genevieve, Mehrabi Arianeb, Sauer Peter, Büchler Markus W, Schmidt Jan, Kraus Thomas W, Schemmer Peter
Department of Surgery, University of Heidelberg, Heidelberg, Germany.
Clin Transplant. 2006 Mar-Apr;20(2):151-5. doi: 10.1111/j.1399-0012.2005.00456.x.
Liver transplantation (LT) in an adult with situs inversus (SI) is extremely rare and requires precise pre-operative management. A 48-yr-old male with SI suffering from alcoholic liver cirrhosis underwent LT at our institution in March 2003. Pre-operatively, liver anatomy was determined by CT scan, three-dimensional liver reconstruction and angiography. LT was performed using the Belghiti technique with side-to-side cavo-caval anastomosis, transplanting a graft from a donor with normal anatomy. Post-operatively, the patient recovered without major complications, except an epileptic event because of a central pontine myelinolysis, and he was discharged on the 25th post-operative day. Three months after surgery, the T-drain placed intra-operatively into the donor bile duct was removed; transplant perfusion and function were stable with an actual follow-up period of 24 months. LT in patients with SI is feasible. Pre-operative imaging with three-dimensional reconstruction is a beneficial tool for operation planning in patients with rare anatomic variations.
在患有内脏反位（SI）的成年人中进行肝移植（LT）极为罕见，需要精确的术前管理。一名48岁患有SI的男性酒精性肝硬化患者于2003年3月在我院接受了LT。术前，通过CT扫描、三维肝脏重建和血管造影确定肝脏解剖结构。采用Belghiti技术进行LT，行端侧腔静脉吻合，移植来自解剖结构正常供体的移植物。术后，患者恢复良好，无重大并发症，仅因中央桥脑髓鞘溶解发生一次癫痫事件，术后第25天出院。术后三个月，术中置于供体胆管的T形引流管被拔除；移植灌注和功能稳定，实际随访期为24个月。SI患者进行LT是可行的。三维重建的术前成像对于解剖结构罕见变异患者的手术规划是一种有益的工具。
