Dulundu Ender, Sugawara Yasuhiko, Kishi Yoji, Akamatsu Nobuhisa, Kokudo Norihiro, Makuuchi Masatoshi
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine University of Tokyo, Japan.
Hepatogastroenterology. 2006 Sep-Oct;53(71):778-80.
BACKGROUND/AIMS: Despite the impressive results of living donor liver transplantation, hepatic venous reconstruction remains a controversial component.
A total of 211 consecutive donor hepatectomies were performed. The proximal route of the hepatic vein was exposed by dissection of the connective tissue around the hepatic vein and by dividing and ligating all of the inferior phrenic veins that open into the hepatic vein, into the confluence of the hepatic vein and inferior vena cava, or directly into the inferior vena cava.
In the 114 left-side hepatectomy procedures, the number of divided left inferior phrenic veins ranged from 1 to 4 and the diameters of the left and middle hepatic veins ranged from 7 to 33mm. For the 97 right-side procedures, the number of divided right inferior phrenic veins ranged from 1 to 4 and the diameters of right hepatic veins ranged from 9 to 34mm. This maneuver safely allowed for the safe exposure of all trunks and routes of the hepatic veins and the suprahepatic portion of the inferior vena cava.
Our technique is useful for obtaining a wide ostium and a sufficient length of the hepatic vein for grafts obtained from living donors.
背景/目的：尽管活体肝移植取得了令人瞩目的成果，但肝静脉重建仍是一个存在争议的部分。
共进行了211例连续的供体肝切除术。通过解剖肝静脉周围的结缔组织，并结扎所有汇入肝静脉、肝静脉与下腔静脉汇合处或直接汇入下腔静脉的膈下静脉，暴露肝静脉的近端路径。
在114例左侧肝切除术中，结扎的左膈下静脉数量为1至4条，左、中肝静脉直径为7至33毫米。在97例右侧手术中，结扎的右膈下静脉数量为1至4条，右肝静脉直径为9至34毫米。该操作安全地暴露了所有肝静脉主干和路径以及下腔静脉肝上段。
我们的技术有助于为活体供肝获取宽开口和足够长度的肝静脉。
