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微创供肝切除术:系统评价。

Minimally invasive donor hepatectomy, systemic review.

机构信息

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Ulsan University and Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, 138-736, Seoul, Republic of Korea.

Department of Surgery, Division of Liver Transplantation and Hepatobiliary Surgery, Weill Cornell Medical College, Weill Cornell Medicine, 525 East 68th St, 10065, New York, NY, USA.

出版信息

Int J Surg. 2020 Oct;82S:187-191. doi: 10.1016/j.ijsu.2020.06.023. Epub 2020 Jun 29.

Abstract

Liver transplantation is a life-saving therapy for patients with end-stage liver disease. Living donation is a critical source of organs throughout the world. Reducing donor morbidity and mortality is of utmost importance while maintaining access to liver transplantation for recipients. While laparoscopy was more rapidly utilized in donor nephrectomy, laparoscopy has been slower to develop for living donor hepatectomies due to the concerns about hemostasis, safety of the donor and quality of the graft. Pure minimal invasive approach has become a standard of care for left lateral sectionectomy (LLS) for pediatric recipients. In the past few years, a number of centers with significant laparoscopic and living donor experience have reported fully minimally invasive approach to hemi-hepatectomies. In this manuscript we discuss the experiences, lessons learned and path forward for laparoscopic and minimal invasive surgery(MIS) in donor hepatectomies (DH).

摘要

肝移植是治疗终末期肝病患者的救命疗法。活体捐赠是全球器官的重要来源。在为受者维持肝移植的同时,降低供者发病率和死亡率至关重要。虽然腹腔镜在供肾切除术上的应用更为迅速,但由于对止血、供者安全和移植物质量的担忧,腹腔镜在活体肝切除术上的发展较为缓慢。对于儿科受者的左外叶切除术(LLS),纯微创方法已成为一种标准的治疗方法。在过去的几年中,一些具有丰富腹腔镜和活体供者经验的中心已经报告了完全微创的半肝切除术方法。在本文中,我们讨论了腹腔镜和微创外科(MIS)在活体肝切除(DH)中的经验、教训和前进方向。

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