Sanada Yukihiro, Mizuta Koichi, Wakiya Taiichi, Umehara Minoru, Egami Satoshi, Urahashi Taizen, Hishikawa Shuji, Fujiwara Takehito, Sakuma Yasunaru, Hyodo Masanobu, Yasuda Yoshikazu, Kawarasaki Hideo
Department of Transplant Surgery, Jichi Medical University, Tochigi, 329-0498, Japan.
Pediatr Surg Int. 2011 Jan;27(1):23-7. doi: 10.1007/s00383-010-2722-2.
Bowel perforation after liver transplantation (LT) is a rare, but highly lethal complication with a poor prognosis. Here, we report the outcome of cases of bowel perforation after pediatric LT in our department.
The study subjects were 148 patients who underwent pediatric living donor liver transplantation. The 114 with biliary atresia (BA) were divided into two groups: those with associated bowel perforation (Group A) and those without (Group B).
Four patients in all (2.5%) suffered bowel perforation. Their original disease was BA and emergency surgery was performed in all cases, with a mortality rate of 50.0%. Comparison of Groups A and B revealed significant differences in the patient age, body weight, duration of surgery, cold ischemic time, and blood loss volume. The survival rates in Groups A and B were 50.0 and 99.1%, respectively (p < 0.01). Duration of surgery was an independent risk factor (p = 0.05).
Bowel perforation after LT is a potentially fatal complication. LT is a procedure that requires care and precision, and the possibility of bowel perforation should always be borne in mind during post-operative management, when the duration of surgery has been long.
肝移植（LT）后肠穿孔是一种罕见但致死率很高且预后较差的并发症。在此，我们报告我院小儿肝移植后肠穿孔病例的结果。
研究对象为148例行小儿活体供肝移植的患者。114例患有胆道闭锁（BA）的患者被分为两组：伴有肠穿孔的患者（A组）和无肠穿孔的患者（B组）。
总共有4例患者（2.5%）发生肠穿孔。他们的原发病均为BA，所有病例均进行了急诊手术，死亡率为50.0%。A组和B组在患者年龄、体重、手术时间、冷缺血时间和失血量方面存在显著差异。A组和B组的生存率分别为50.0%和99.1%（p<0.01）。手术时间是一个独立的危险因素（p=0.05）。
肝移植后肠穿孔是一种潜在的致命并发症。肝移植是一项需要谨慎和精确操作的手术，在术后管理中，当手术时间较长时，应始终牢记肠穿孔的可能性。
