Chinese PLA Medical School, Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China.
Chinese PLA Medical School, Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China -
Minerva Surg. 2021 Aug;76(4):388-394. doi: 10.23736/S2724-5691.18.07546-6. Epub 2020 Nov 9.
Although uncommon during hepatobiliary-pancreatic (HBP) surgery, iatrogenic intraoperative injury to a major artery requires prompt and appropriate repair. Here, we outline our surgical experience with the repair of this injury and compare our experience to findings garnered from a selective review of the literature.
We retrospectively analyzed the clinical diagnoses, surgical methods, sites of arterial injury, operative repair, intra-operative blood loss, blood transfusion requirements, postoperative management and outcome of 17 consecutive patients who sustained iatrogenic intra-operative injuries to major arteries during HBP surgery between January 2008 and December 2013.
Depending on the location and extent of injury, suture repair, primary end-to-end anastomosis, artery transposition, interposition grafting, or arterio-portal shunting were used. Postoperative morbidity occurred in three cases and there was only one case of in-hospital mortality (5.9%). No arterial thrombosis or other repair-related complications were found after the operation with a follow-up duration of 6 months.
The use of an optimal repair method for injured arteries based on their location and extent resulted in a satisfactory outcome.
虽然在肝胆胰（HBP）手术中并不常见，但医源性术中主要动脉损伤需要及时和适当的修复。在这里，我们总结了我们对这种损伤的手术经验，并将我们的经验与从文献选择性回顾中获得的结果进行了比较。
我们回顾性分析了 2008 年 1 月至 2013 年 12 月期间 17 例连续接受 HBP 手术的患者的临床诊断、手术方法、动脉损伤部位、手术修复、术中失血量、输血需求、术后管理和结果，这些患者术中发生医源性主要动脉损伤。
根据损伤的位置和程度，采用缝合修复、端端吻合、动脉移位、间置移植或动静脉分流。术后发生 3 例并发症，仅 1 例院内死亡（5.9%）。术后随访 6 个月，无动脉血栓形成或其他与修复相关的并发症。
根据损伤动脉的位置和程度，采用最佳的修复方法，可获得满意的结果。
