Tashiro Hirotaka, Itamoto Toshiyuki, Ohdan Hideki, Oshita Akihiko, Fudaba Yasuhiro, Ishiyama Kohei, Kohashi Toshihiko, Amano Hironobu, Fukuda Saburo, Asahara Toshimasa
Second Department of Surgery, Faculty of Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Surg Today. 2008;38(3):289-91. doi: 10.1007/s00595-007-3603-8. Epub 2008 Feb 29.
A right liver graft lacking the middle hepatic vein can result in congestion of the anterior segment. We describe a method of reconstructing the middle hepatic vein tributaries by using the recipient's own middle hepatic vein with vascular closure staples. During a living donor right liver transplantation, the middle hepatic vein tributaries draining segments V (V5) and VIII (V8) of the right lobe graft were reconstructed using the recipient's own middle hepatic vein and secured with vascular closure staples. Computed tomography showed good venous outflow from the middle hepatic vein and no congestion or atrophy of the anterior segment of the right liver grafts. Thus, using the recipient's own middle hepatic vein is a suitable option for reconstructing the middle hepatic vein tributaries (V8 and V5) in right-liver living donor transplantation and the application of vascular closure staples helps to accomplish this.
缺乏肝中静脉的右肝移植可能导致前段肝淤血。我们描述了一种使用受体自身肝中静脉及血管闭合吻合器重建肝中静脉属支的方法。在活体供肝右肝移植术中,利用受体自身肝中静脉重建右叶移植肝V段(V5)和VIII段(V8)的肝中静脉属支,并用血管闭合吻合器固定。计算机断层扫描显示肝中静脉有良好的静脉流出道,右肝移植肝前段无淤血或萎缩。因此,在活体供肝右肝移植中,利用受体自身肝中静脉重建肝中静脉属支(V8和V5)是一种合适的选择,而血管闭合吻合器的应用有助于实现这一点。