Wang Hanjay, Griesemer Adam D, Parsons Ronald F, Graham Jay A, Emond Jean C, Samstein Benjamin
Center for Liver Disease and Transplantation, Department of Surgery, Columbia University Medical Center, New York, NY 10032, USA.
Department of Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA.
Case Rep Transplant. 2014;2014:582183. doi: 10.1155/2014/582183. Epub 2014 Dec 25.
Delayed gastric emptying is a significant postoperative complication of living donor hepatectomy for liver transplantation and may require endoscopic or surgical intervention in severe cases. Although the mechanism of posthepatectomy delayed gastric emptying remains unknown, vagal nerve injury during intraoperative dissection and adhesion formation postoperatively between the stomach and cut liver surface are possible explanations. Here, we present the first reported case of delayed gastric emptying following fully laparoscopic hepatectomy for living donor liver transplantation. Additionally, we also present a case in which symptoms developed after open right hepatectomy, but for which dissection for left hepatectomy was first performed. Through our experience and these two specific cases, we favor a neurovascular etiology for delayed gastric emptying after hepatectomy.
胃排空延迟是活体肝移植供体肝切除术后的一种重要并发症,严重时可能需要内镜或手术干预。尽管肝切除术后胃排空延迟的机制尚不清楚,但术中解剖时迷走神经损伤以及术后胃与肝切除断面之间形成粘连可能是其原因。在此,我们报告首例完全腹腔镜活体肝移植供体肝切除术后发生胃排空延迟的病例。此外,我们还报告了一例在开放性右半肝切除术后出现症状,但首先进行左半肝切除解剖的病例。通过我们的经验以及这两个具体病例,我们认为肝切除术后胃排空延迟的病因是神经血管性的。