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在肝移植中使用胃左静脉作为门静脉血流重建的替代方法。

Use of Left Gastric Vein as an Alternative for Portal Flow Reconstruction in Liver Transplantation.

作者信息

Teixeira Uirá Fernandes, Machry Mayara Christ, Goldoni Marcos Bertozzi, Kruse Cristine, Diedrich João Alfredo, Rodrigues Pablo Duarte, Giacomazzi Caroline Becker, Negri Estéfano Aurélio, Koop Matheus, Gomes Carlos Gustavo Spode, Sampaio José Artur, Fontes Paulo Roberto Ott, Waechter Fábio Luiz

机构信息

Gastrointestinal and Hepato-Pancreato-Biliary Surgical Division, Universidade Federal de Ciências da Saúde de Porto Alegre and Hospital Santa Casa de Porto Alegre, 90420121 Porto Alegre, RS, Brazil.

Pontifícia Universidade Católica (PUC), Porto Alegre, RS, Brazil.

出版信息

Case Rep Surg. 2016;2016:8289045. doi: 10.1155/2016/8289045. Epub 2016 Aug 9.

DOI:10.1155/2016/8289045
PMID:27595034
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4993930/
Abstract

Portal vein thrombosis is observed in up to 10% of liver transplant candidates, hindering execution of the procedure. A dilated gastric vein is an alternative to portal vein reconstruction and decompression of splanchnic bed. We present two cases of patients with portal cavernoma and dilated left gastric vein draining splanchnic bed who underwent liver transplantation. The vein was dissected and sectioned near the cardia; the proximal segment was ligated with suture and the distal segment was anastomosed to the donor portal vein. Gastroportal anastomosis is an excellent option for portal reconstruction in the presence of thrombosis or hypoplasia. It allows an adequate splanchnic drainage and direction of hepatotrophic factors to the graft.

摘要

在高达10%的肝移植候选者中观察到门静脉血栓形成，这阻碍了手术的实施。扩张的胃静脉是门静脉重建和内脏床减压的替代方法。我们报告了两例患有门静脉海绵样变性且内脏床引流的扩张左胃静脉的患者接受肝移植的病例。在贲门附近解剖并切断该静脉；近端用缝线结扎，远端与供体门静脉吻合。胃肠门静脉吻合术是存在血栓形成或发育不全时门静脉重建的极佳选择。它能实现充分的内脏引流，并使促肝细胞生长因子流向移植物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/d295d17655e3/CRIS2016-8289045.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/c66bf84910b5/CRIS2016-8289045.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/8fc140f662b0/CRIS2016-8289045.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/d60b2e38c235/CRIS2016-8289045.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/d5b4a84cbbe9/CRIS2016-8289045.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/d295d17655e3/CRIS2016-8289045.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/c66bf84910b5/CRIS2016-8289045.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/8fc140f662b0/CRIS2016-8289045.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/d60b2e38c235/CRIS2016-8289045.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/d5b4a84cbbe9/CRIS2016-8289045.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9234/4993930/d295d17655e3/CRIS2016-8289045.005.jpg

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引用本文的文献

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World J Transplant. 2022 Jul 18;12(7):204-210. doi: 10.5500/wjt.v12.i7.204.
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Intraoperative Challenge for Vascular Reconstruction in Orthotopic Liver Transplantation Because of Extensive Portal Thrombosis and Intimal Dissection of the Hepatic Artery.

本文引用的文献

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Portal Vein Thrombosis Is a Risk Factor for Poor Early Outcomes After Liver Transplantation: Analysis of Risk Factors and Outcomes for Portal Vein Thrombosis in Waitlisted Patients.门静脉血栓形成是肝移植术后早期预后不良的危险因素：对等待名单上患者门静脉血栓形成的危险因素及预后分析
Transplantation. 2016 Jan;100(1):126-33. doi: 10.1097/TP.0000000000000785.
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Association between portal vein thrombosis and survival of liver transplant recipients: a systematic review and meta-analysis of observational studies.门静脉血栓形成与肝移植受者生存率之间的关联：一项观察性研究的系统评价和荟萃分析
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原位肝移植中因广泛门静脉血栓形成和肝动脉内膜剥离导致的血管重建术中挑战
ACG Case Rep J. 2020 Jun 25;7(6):e00390. doi: 10.14309/crj.0000000000000390. eCollection 2020 Jun.
Portal vein thrombosis in cirrhosis.
肝硬化中的门静脉血栓形成
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World J Hepatol. 2014 Aug 27;6(8):549-58. doi: 10.4254/wjh.v6.i8.549.
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Portal vein thrombosis in liver transplantation.肝移植中的门静脉血栓形成
Arq Bras Cir Dig. 2012 Oct-Dec;25(4):273-8. doi: 10.1590/s0102-67202012000400012.
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