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在活体肝移植中使用膨体聚四氟乙烯血管移植物进行静脉流出道重建:单中心经验

Venous outflow reconstruction using an expanded polytetrafluoroethylene vascular graft in living-donor liver transplant: a single-center experience.

作者信息

Lai Chia-Yu, Han Shao-Min, Chen Yi-Ju, Huang Shou-Sen, Wu Cheng-Chung, Cheng Shao-Bin

机构信息

Division of General Surgery and Liver Transplantation, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

Exp Clin Transplant. 2014 Jun;12(3):241-5.

Abstract

OBJECTIVES

Limited studies have focused on the feasibility and technical requirements of using expanded polytetrafluoroethylene vessel grafts for venous outflow reconstruction in a living-donor liver transplant using right liver grafts without the middle hepatic vein.

MATERIALS AND METHODS

Between August 2007 and December 2012, thirty-two patients who had received an expanded polytetrafluoroethylene vascular graft for outflow reconstruction during a living-donor liver transplant using a right liver graft without the middle hepatic vein were retrospectively reviewed. Preoperative and operative data, complications, and mortality were compared among patients who received the expanded polytetrafluoroethylene grafts with individual anastomoses (n = 18) or confluent anastomoses (n =14).

RESULTS

For patients who had received an individual and a confluent anastomosis, graft reconstruction time was 25.8 and 14.9 minutes (P = .000). No cases of graft occlusion occurred during first 72 hours after surgery. Although 5 patients (15.6%) died within 90 days, none of the deaths were associated with the vascular grafts. Operative mortality was not statistically different between patients who had received an individual anastomosis (3/18, 16.7%) and those who had received a confluent anastomosis (2/14, 14.3%) (P = 1.000).

CONCLUSIONS

Individual and confluent anastomoses using an expanded polytetrafluoroethylene vascular graft is a feasible approach to venous outflow reconstruction in a living-donor liver transplant using right liver grafts without the middle hepatic vein.

摘要

目的

针对在使用不含肝中静脉的右肝移植物的活体肝移植中,运用膨体聚四氟乙烯血管移植物进行静脉流出道重建的可行性及技术要求,相关研究有限。

材料与方法

回顾性分析2007年8月至2012年12月期间,32例在使用不含肝中静脉的右肝移植物的活体肝移植中接受膨体聚四氟乙烯血管移植物进行流出道重建的患者。比较接受单独吻合(n = 18)或汇合吻合(n = 14)的膨体聚四氟乙烯移植物患者的术前和手术数据、并发症及死亡率。

结果

接受单独吻合和汇合吻合的患者,移植物重建时间分别为25.8分钟和14.9分钟(P = .000)。术后72小时内未发生移植物闭塞病例。尽管5例患者(15.6%)在90天内死亡,但均与血管移植物无关。接受单独吻合的患者(3/18,16.7%)与接受汇合吻合的患者(2/14,14.3%)的手术死亡率无统计学差异(P = 1.000)。

结论

在使用不含肝中静脉的右肝移植物的活体肝移植中,采用膨体聚四氟乙烯血管移植物进行单独吻合和汇合吻合是静脉流出道重建的可行方法。

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