Department of Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
Liver Transpl. 2010 Jan;16(1):33-7. doi: 10.1002/lt.21934.
In living donor liver transplantation (LDLT), bile duct reconstruction is often technically demanding due to the frequently anomalous anatomy of the bile duct, as well as the high incidence of biliary complications. A bile duct branch may also be accidentally left without anastomosis at the time of LDLT and found to be obstructed after surgery. Surgical revision for such cases is sometimes not feasible because of the invasiveness of the procedure. We report a case in which a bile duct branch was intentionally left without anastomosis and was later successfully anastomosed to the cystic duct stump using a magnetic compression anastomosis (MCA) technique. A combination of the MCA technique and cystic duct anastomosis is life-saving in certain situations and should be considered as the treatment of choice.
在活体肝移植 (LDLT) 中,由于胆管解剖结构经常异常,以及胆道并发症的高发率,胆管重建通常具有很高的技术要求。在 LDLT 时,胆管的一个分支也可能意外地未进行吻合,并且在手术后发现被阻塞。对于这种情况,手术修正有时由于手术的侵袭性而不可行。我们报告了一例胆管分支未进行吻合而被故意留下,然后使用磁性压缩吻合 (MCA) 技术成功地吻合到胆囊管残端的病例。MCA 技术和胆囊管吻合术的结合在某些情况下是救命的,应被视为首选治疗方法。