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75例活体供肝肝移植右半肝切除术的手术及围手术期并发症分析

Analysis of surgical and perioperative complications in seventy-five right hepatectomies for living donor liver transplantation.

作者信息

Gruttadauria Salvatore, Marsh James Wallis, Vizzini Giovan Battista, di Francesco Fabrizio, Luca Angelo, Volpes Riccardo, Marcos Amadeo, Gridelli Bruno

机构信息

Department of Abdominal Transplant Surgery, Istituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione, Palermo 90127, Italy.

出版信息

World J Gastroenterol. 2008 May 28;14(20):3159-64. doi: 10.3748/wjg.14.3159.

Abstract

AIM

To present an analysis of the surgical and perioperative complications in a series of seventy-five right hepatectomies for living-donation (RHLD) performed in our center.

METHODS

From January 2002 to September 2007, we performed 75 RHLD, defined as removal of a portion of the liver corresponding to Couinaud segments 5-8, in order to obtain a graft for adult to adult living-related liver transplantation (ALRLT). Surgical complications were stratified according to the most recent version of the Clavien classification of postoperative surgical complications. The perioperative period was defined as within 90 d of surgery.

RESULTS

No living donor mortality was present in this series, no donor operation was aborted and no donors received any blood transfusion. Twenty-three (30.6%) living donors presented one or more episodes of complication in the perioperative period. Seven patients (9.33%) out of 75 developed biliary complications, which were the most common complications in our series.

CONCLUSION

The need to define, categorize and record complications when healthy individuals, such as living donors, undergo a major surgical procedure, such as a right hepatectomy, reflects the need for prompt and detailed reports of complications arising in this particular category of patient. Perioperative complications and post resection liver regeneration are not influenced by anatomic variations or patient demographic.

摘要

目的

对本中心进行的75例活体右半肝切除术(RHLD)的手术及围手术期并发症进行分析。

方法

2002年1月至2007年9月,我们进行了75例RHLD,即切除相当于Couinaud 5-8段的部分肝脏,以获取用于成人对成人活体肝移植(ALRLT)的移植物。手术并发症根据最新版的Clavien术后手术并发症分类进行分层。围手术期定义为手术90天内。

结果

本系列中无活体供者死亡,无供者手术中止,无供者接受输血。23例(30.6%)活体供者在围手术期出现1次或多次并发症。75例中有7例(9.33%)发生胆道并发症,是本系列中最常见的并发症。

结论

当健康个体如活体供者接受诸如右半肝切除术这样的大手术时需要定义、分类和记录并发症,这反映了对这类特殊患者出现的并发症进行及时和详细报告的必要性。围手术期并发症和肝切除术后肝脏再生不受解剖变异或患者人口统计学因素的影响。

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