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肝右叶活体供肝移植中包含和不包含中肝静脉时右肝叶体积和重量与术前的关系。

Relationship between preoperative volume and weight of the right liver lobe graft, with and without the middle hepatic vein, in living-donor transplantation.

机构信息

CETEFI-Centro Terapêutico Especializado em Fígado, Hospital Beneficência Portuguesa de São Paulo, São Paulo, Brazil.

出版信息

World J Surg. 2013 Jan;37(1):202-7. doi: 10.1007/s00268-012-1778-7.

DOI:10.1007/s00268-012-1778-7
PMID:22976791
Abstract

BACKGROUND

The aim of this study was to assess the relationship between the preoperative volume of the right liver lobe (as determined by computed tomography) and the intraoperative graft weight with or without the middle hepatic vein.

METHODS

Sixty-three patients who underwent liver transplantation were included in this study. The preoperative volumes of both the left and the right liver lobe were measured in all patients using computed tomography. The intraoperative weight of the right liver lobe was also measured with (group 1, n = 29) and without (group 2, n = 34) the middle hepatic vein. The results were compared with respect to gender, age, body weight, height, body mass index (BMI), weights of the left and right liver lobes as measured by computed tomography, and intraoperative weight of the right liver lobe.

RESULTS

A 21.64 % difference was observed between the weight of the right liver lobe as measured by computed tomography and the weight of the right lobe without the hepatic vein as measured intraoperatively (group 2). Moreover, a 12.38 % difference was observed between the weight of the right liver lobe as measured by computed tomography and the weight of the right lobe plus the middle hepatic vein as measured intraoperatively (group 1).

CONCLUSIONS

The weight of the right liver lobe graft in a living-donor transplantation is less than that calculated by preoperative computed tomography, and the inclusion of the middle hepatic vein in the right liver lobe graft resulted in a statistically significant decrease in this difference.

摘要

背景

本研究旨在评估术前右肝体积(通过计算机断层扫描确定)与术中供肝重量(包括或不包括中肝静脉)之间的关系。

方法

本研究纳入了 63 例行肝移植的患者。所有患者均通过计算机断层扫描测量左、右肝叶的术前体积。同时测量有(组 1,n=29)和无(组 2,n=34)中肝静脉的右肝叶术中重量。比较两组患者的性别、年龄、体重、身高、体重指数(BMI)、计算机断层扫描测量的左、右肝叶重量以及右肝叶术中重量。

结果

计算机断层扫描测量的右肝叶重量与术中无静脉的右肝叶重量(组 2)之间存在 21.64%的差异。此外,计算机断层扫描测量的右肝叶重量与术中右肝叶加中肝静脉的重量(组 1)之间存在 12.38%的差异。

结论

活体供肝移植中右肝叶供肝的重量小于术前计算机断层扫描计算的重量,而中肝静脉包含在右肝叶供肝中会导致这种差异的统计学显著降低。

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本文引用的文献

1
Living donor right liver lobe transplantation with or without inclusion of the middle hepatic vein: analysis of complications.活体肝右叶移植伴或不伴中肝静脉的纳入:并发症分析。
World J Surg. 2011 Feb;35(2):403-8. doi: 10.1007/s00268-010-0857-x.
2
Accurate and reasonable method for estimation of graft volume in living donor liver transplantation.活体肝移植中移植物体积估计的准确合理方法。
Transplantation. 2008 Oct 15;86(7):1011-2. doi: 10.1097/TP.0b013e3181875959.
3
V. Notes on the Arrest of Hepatic Hemorrhage Due to Trauma.
五、创伤性肝出血的止血注意事项
Ann Surg. 1908 Oct;48(4):541-9. doi: 10.1097/00000658-190810000-00005.
4
Preoperative volume prediction in adult living donor liver transplantation: how much can we rely on it?成人活体肝移植术前体积预测:我们能在多大程度上依赖它?
Am J Transplant. 2007 Mar;7(3):672-9. doi: 10.1111/j.1600-6143.2006.01656.x. Epub 2007 Jan 4.
5
Preoperative helical computerized tomography estimation of donor liver volume.术前螺旋计算机断层扫描评估供肝体积。
Transplant Proc. 2006 Nov;38(9):2941-7. doi: 10.1016/j.transproceed.2006.08.106.
6
Problems in adult living donor liver transplantation using the right hepatic lobe.成人活体供肝右半肝移植中的问题
Hepatobiliary Pancreat Dis Int. 2006 Aug;5(3):345-9.
7
Living donor right liver lobes: preoperative CT volumetric measurement for calculation of intraoperative weight and volume.活体供体右肝叶:术前CT容积测量以计算术中重量和体积。
Radiology. 2006 Sep;240(3):736-42. doi: 10.1148/radiol.2403042062. Epub 2006 Jul 25.
8
Estimating liver weight of adults by body weight and gender.通过体重和性别估算成年人的肝脏重量。
World J Gastroenterol. 2006 Apr 14;12(14):2217-22. doi: 10.3748/wjg.v12.i4.2217.
9
Liver graft volume estimation in 100 living donors: measure twice, cut once.100例活体供肝者肝脏体积的评估:三思而后行。
Transplantation. 2005 Nov 15;80(9):1181-5. doi: 10.1097/01.tp.0000173772.94929.e6.
10
Living donor liver transplantation in Japan and Kyoto University: what can we learn?日本及京都大学的活体供肝移植:我们能学到什么?
J Hepatol. 2005 Jan;42(1):25-8. doi: 10.1016/j.jhep.2004.11.004.