Department of Anesthesiology, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Clin Transplant. 2010 Sep-Oct;24(5):585-91. doi: 10.1111/j.1399-0012.2009.01145.x.
Surgical advances using the retrohepatic caval preservation technique in liver transplantation (LT) has significantly decreased the need for veno-venous bypass (VVB). However, VVB still remains a viable adjunct of LT. The venous return cannula has traditionally been inserted using a cut-down technique via the axillary vein, but this technique carries significant risks for lymphorrhea, infection, or nerve damage. Since 2001, our institution has routinely used VVB in adult LT surgery. Percutaneous insertion of an internal jugular venous return cannula is performed by the attending anesthesiologist. The aim of this report is to describe the method of insertion and management of a percutaneous veno-venous return cannula in the internal jugular vein during LT. In-depth detail as well as video clips will provide a reference for LT centers wishing to apply this method in their practice.
肝移植（LT）中采用肝后下腔静脉保留技术的外科进展显著降低了静脉-静脉转流（VVB）的需求。然而，VVB 仍然是 LT 的一种可行的辅助手段。静脉回流插管传统上通过腋静脉进行切开技术插入，但该技术存在淋巴漏、感染或神经损伤的显著风险。自 2001 年以来，我们机构在成人 LT 手术中常规使用 VVB。经皮插入颈内静脉回流插管由主治麻醉师完成。本报告的目的是描述在 LT 期间经皮颈内静脉插入 VVB 的方法和管理。详细的描述和视频片段将为希望在实践中应用这种方法的 LT 中心提供参考。
