Department of Hepatobiliary Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
Cell Biochem Biophys. 2014 Jan;68(1):55-65. doi: 10.1007/s12013-013-9694-5.
Rat orthotopic liver transplantation (ROLT) remains a technically demanding procedure, especially regarding the reconstruction of the suprahepatic vena cava (SHVC). In this study, a new microsuture technique was developed for anastomosis of the SHVC, and a special single-groove cuff and blade-cut stent were introduced. With these modified techniques, we aimed to make a precise anastomosis of the SHVC and to provide optimal cuffs and stents for the reconstruction of the veins and bile ducts. According to different microsuture techniques for the SHVC and different types of cuffs and stents, three ROLT groups were created to compare the operation times and prognoses. Sham operations were performed as controls in the fourth group. The time expenditures with each step were compared among the transplantation groups. Biochemical parameters were tested at the end of a 1-month observation period. The short- and long-term survival rates of the transplantation groups were recorded and compared. Our new microsuture technique was faster than the conventional continuous suture technique for SHVC anastomosis (P < 0.05). The use of a single-groove cuff for reconstruction of the portal vein and the infrahepatic vena cava shortened the anastomotic time (P < 0.05). The use of blade-cut stents resulted in fewer biliary complications and better survival over the short and long terms (P < 0.05). Our new microsuture technique and the single-groove cuffs proved to be a precise method for venous reconstruction which shortened the anhepatic time and the anastomotic time significantly. The blade-cut stents apparently reduced the incidence of biliary complications. In summary, with this precise microsuture technique and delicate cuffs and stents, excellent long-term survival can be achieved easily and stably for ROLT.
大鼠原位肝移植（ROLT）仍然是一项技术要求很高的手术，尤其是在肝上腔静脉（SHVC）重建方面。在这项研究中，开发了一种新的 SHVC 吻合显微缝合技术，并引入了特殊的单槽袖套和刀片切割支架。通过这些改良技术，我们旨在精确吻合 SHVC，并为静脉和胆管重建提供最佳的袖套和支架。根据 SHVC 的不同显微缝合技术以及不同类型的袖套和支架，创建了三个 ROLT 组，以比较手术时间和预后。第四组进行假手术作为对照。比较移植组中每个步骤的时间消耗。在 1 个月的观察期结束时测试生化参数。记录并比较移植组的短期和长期生存率。我们的新显微缝合技术比 SHVC 吻合的传统连续缝合技术更快（P <0.05）。用于重建门静脉和肝下腔静脉的单槽袖套缩短了吻合时间（P <0.05）。使用刀片切割支架可减少短期和长期的胆道并发症，并提高生存率（P <0.05）。我们的新显微缝合技术和单槽袖套被证明是一种精确的静脉重建方法，可显著缩短无肝时间和吻合时间。刀片切割支架明显降低了胆道并发症的发生率。总之，使用这种精确的显微缝合技术和精细的袖套和支架，ROLT 可以轻松、稳定地实现长期良好的生存。
