Ye Qi-Fa, Niu Ying, She Xing-Guo, Ming Ying-Zi, Cheng Ke, Ma Yin, Ren Zu-Hai
Research Center of National Health Ministry on Transplantation Medicine Engineering and Technology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Hepatobiliary Pancreat Dis Int. 2007 Oct;6(5):470-3.
Bile leak remains a main complication in liver transplantation patients with poor biliary tract conditions, mainly caused by an insufficient blood supply or dysplasia of the biliary tract. Although Roux-en-Y modus operandi can be adopted, the risk of other complications of the biliary tract such as infection increases. Using pedicled greater omentum flaps to wrap the anastomotic stoma, which increases the biliary tract blood supply, may reduce the incidence of bile leak.
Fourteen patients undergoing piggy-back liver transplantation and having poor biliary tract conditions were treated with pedicled greater omentum flaps to wrap the anastomotic stoma of the biliary tract. Their clinical data were analyzed retrospectively.
Of the 14 patients, only one (7.1%) had a mild bile leak on the 8th day post-operation and fully recovered after symptomatic treatment. The other patients had no biliary complications.
Using pedicled greater omentum flaps to wrap the anastomotic stoma of the biliary tract is an effective way to prevent bile leak in liver transplantation patients, especially those with poor biliary tract conditions. However, experience with this surgical technique still needs to be further explored.
胆漏仍是胆道条件较差的肝移植患者的主要并发症，主要由胆道血供不足或发育异常引起。虽然可采用Roux-en-Y手术方式，但胆道感染等其他并发症的风险会增加。使用带蒂大网膜瓣包裹吻合口，可增加胆道血供，可能降低胆漏发生率。
对14例行背驮式肝移植且胆道条件较差的患者，采用带蒂大网膜瓣包裹胆道吻合口进行治疗。对其临床资料进行回顾性分析。
14例患者中，仅1例（7.1%）术后第8天出现轻度胆漏，经对症治疗后完全康复。其他患者未出现胆道并发症。
使用带蒂大网膜瓣包裹胆道吻合口是预防肝移植患者胆漏的有效方法，尤其是胆道条件较差的患者。然而，这种手术技术的经验仍需进一步探索。
