使用自体腹膜移植治疗钝性胸腹联合伤所致门静脉损伤。
Using autologous peritoneal graft for portal vein injury due to blunt thoracoabdominal trauma.
作者信息
Sabuncuoglu M Z, Dandin O, Teomete U, Cakir T, Kayaalp C
机构信息
Department of General Surgery, Faculty of Medicine, University Of Suleyman Demirel, Isparta, Turkey.
Division of Trauma and Acute Care Surgery, Department of Surgery, Isparta, Turkey.
出版信息
Hippokratia. 2015 Jul-Sep;19(3):260-2.
BACKGROUND
Autologous vein or prosthetic materials are used as patch or tube graft for portal or caval vein reconstruction after trauma or tumor resection. Preparation of autologous veins requires extra incisions and is time consuming that is crucial especially in trauma patients. This condition adversely affects postoperative morbidity and mortality, particularly in trauma cases. Prosthetic materials may not be available in some centers, and their use is associated with an increased risk of infection.
DESCRIPTION OF CASE
A 28-year-old hemodynamically unstable man presented to the emergency room with complete transection of main portal vein, right hepatic artery and common bile duct with tissue defect on hepatoduodenal ligament due to blunt thoracoabdominal trauma. Reconstructing of the portal vein was performed using an autologous peritoneal tube graft.
CONCLUSION
Autologous peritoneal graft is a very good option in the treatment of major vascular injuries which can not be repaired with primary suturing. It is also easy to prepare and use, safe, without a need of additional incision, as an alternative to autologous veins and prosthetic materials especially under emergency conditions. Hippokratia 2015; 19 (3): 260-262.
背景
自体静脉或人工材料被用作补片或管状移植物，用于创伤或肿瘤切除术后门静脉或腔静脉的重建。自体静脉的制备需要额外的切口且耗时较长，这一点在创伤患者中尤为关键。这种情况会对术后发病率和死亡率产生不利影响，尤其是在创伤病例中。在一些中心可能无法获得人工材料，并且使用它们会增加感染风险。
病例描述
一名28岁血流动力学不稳定的男性因钝性胸腹外伤导致门静脉主干、右肝动脉和胆总管完全横断，肝十二指肠韧带存在组织缺损，被送往急诊室。使用自体腹膜管状移植物进行门静脉重建。
结论
自体腹膜移植物是治疗无法通过一期缝合修复的重大血管损伤的一个非常好的选择。它制备和使用简便、安全，无需额外切口，可作为自体静脉和人工材料的替代物，尤其是在紧急情况下。《希波克拉底》2015年；19（3）：260 - 262。
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