Su F, He E, Qian L, Zhu Z, Wei L, Zeng Z, Qu W, Xu R, Yi Z
Department of Ultrasound, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China.
Department of Ultrasound, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China.
Transplant Proc. 2018 Jan-Feb;50(1):217-221. doi: 10.1016/j.transproceed.2017.12.013.
Preserving the donor's gallbladder during living donor liver transplantation (LDLT) is a better method for liver transplantation surgery, but not enough is known about gallbladder complications after the operation.
We retrospectively investigated postsurgical donor gallbladder complications in clinical LDLT with gallbladder preservation. The feasibility of retaining the gallbladder during liver graft procurement is discussed. Ninety-one donors with retained gallbladder after LDLT with the hepatic left lateral sectionectomy (from June 2013 to October 2015) were retrospectively analyzed. Donors were followed for 12.6 to 40.7 months after surgery (median 26.1 months). Sonography was used to evaluate gallbladder characteristics before and after surgery.
Gallbladder function had recovered to almost normal 1 month after transplantation. Four donors (4.40%) experienced gallbladder enlargement that resolved after 3 days. Thickening of the gallbladder wall in 31 donors (34.07%) was restored within 2 to 75 days. Biliary sludge appeared in 9 donors (9.89%); 6 of them recovered within 3 to 34 days. Three (3.30%) and 1 donor (1.10%) suffered gallstone and gallbladder polyps, respectively, which persisted until the last follow-up.
The rate of postoperative complications of the gallbladder in donors was relative low. Preserving the gallbladder in liver transplantation donors during liver graft procurement is feasible and safe.
在活体肝移植(LDLT)手术中保留供体胆囊是一种更好的肝移植手术方法,但术后胆囊并发症的相关情况尚不清楚。
我们回顾性研究了临床保留胆囊的LDLT术后供体胆囊并发症情况。讨论了在获取肝移植供肝时保留胆囊的可行性。对91例接受左肝外叶切除的LDLT术后保留胆囊的供体(2013年6月至2015年10月)进行回顾性分析。术后对供体进行了12.6至40.7个月的随访(中位时间26.1个月)。采用超声检查评估手术前后胆囊的特征。
移植后1个月胆囊功能已基本恢复正常。4例供体(4.40%)出现胆囊增大,3天后恢复。31例供体(34.07%)胆囊壁增厚在2至75天内恢复。9例供体(9.89%)出现胆泥;其中6例在3至34天内恢复。分别有3例(3.30%)和1例(1.10%)供体发生胆结石和胆囊息肉,直至最后一次随访时仍存在。
供体胆囊术后并发症发生率相对较低。在获取肝移植供肝时为供体保留胆囊是可行且安全的。