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经脐门静脉置管:左外叶活体肝移植的有用辅助手段。

Transumbilical portal venous catheterization: a useful adjunct in left lobe living donor liver transplantation.

机构信息

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Clin Transplant. 2012 Nov-Dec;26(6):816-9. doi: 10.1111/j.1399-0012.2012.01663.x. Epub 2012 May 15.

Abstract

To improve the processes used for perfusion of the explanted graft and measuring the portal venous pressure (PVP) in adult living donor transplantation (LDLT), we performed transumbilical portal venous catheterization (TPVC) to reopen the umbilical vein and insert the catheter for seven adult patients undergoing left lobe LDLT. There were no major complications as a result of this procedure. This procedure prior to implanting the graft was derived from our experience and is a classic diagnostic technique used during liver surgery. It is a simple and effective procedure for perfusion and washout of the graft and for the safe monitoring of the intraoperative PVP. We hope that this technique for left lobe LDLT will be helpful to others using postoperative PVP monitoring, administration of therapeutic drugs through the portal vein, and temporal portal decompression by preparation of extracorporeal shunting in patients with a small-for-size graft.

摘要

为了改进用于灌注离体移植物和测量成人活体供肝移植(LDLT)中门静脉压力(PVP)的过程,我们对 7 例接受左半肝 LDLT 的患者进行了经脐门静脉置管术(TPVC)以重新开放脐静脉并插入导管。该操作没有导致严重并发症。该操作是在植入移植物之前进行的,源自我们的经验,是肝外科手术中使用的经典诊断技术。它是一种简单有效的灌注和冲洗移植物的方法,也是安全监测术中 PVP 的方法。我们希望这种左半肝 LDLT 技术对于其他术后 PVP 监测、通过门静脉给药治疗药物以及通过体外分流术准备进行临时门静脉减压的小肝供体患者将有所帮助。

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