Kaoutzanis Christodoulos, Evangelakis Erotokritos, Kokkinos Chrysostomos, Kaoutzanis Gavriel
Department of Cardiovascular and Thoracic Surgery, Nicosia General Hospital, Nicosia, Cyprus.
Interact Cardiovasc Thorac Surg. 2011 Jan;12(1):84-6. doi: 10.1510/icvts.2010.249722. Epub 2010 Oct 23.
Traumatic injury to the retrohepatic veins continues to carry high mortality rates. In the last few decades various management strategies have been proposed. However, treatment of such injuries still remains highly variable and technically challenging due to the surgically inaccessible location of these vessels and the consequent difficulty controlling bleeding. We report a successful repair of complete transection of the two main extraparenchymal hepatic veins and laceration of the retrohepatic inferior vena cava using cardiopulmonary bypass (CPB) and hypothermic circulatory arrest (HCA) following blunt abdominal trauma. Immediate CPB with or without HCA can be life-saving and should be considered for patients with complex isolated retrohepatic venous injuries.
肝后静脉创伤性损伤的死亡率仍然很高。在过去几十年里,人们提出了各种治疗策略。然而,由于这些血管的手术位置难以到达,以及由此导致的控制出血困难,此类损伤的治疗仍然高度可变且在技术上具有挑战性。我们报告了一例钝性腹部创伤后,使用体外循环(CPB)和低温循环停止(HCA)成功修复两条主要肝实质外静脉完全横断及肝后下腔静脉撕裂的病例。对于复杂的孤立性肝后静脉损伤患者,立即进行CPB(无论是否使用HCA)可能挽救生命,应予以考虑。