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基于人类胚胎学的供体肝动脉重建:一例报告。

Donor hepatic artery reconstruction based on human embryology: A case report.

作者信息

Zhang He-Zhao, Lu Jun-Hui, Shi Zhi-Yong, Guo Ya-Rong, Shao Wen-Hao, Meng Fan-Xiu, Zhang Rui, Zhang An-Hong, Xu Jun

机构信息

Faculty of Graduate Studies, Shanxi Medical University, Taiyuan 030000, Shanxi Province, China.

Department of Hepatopancreatobiliary Surgery, First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China.

出版信息

World J Gastrointest Surg. 2023 Aug 27;15(8):1825-1830. doi: 10.4240/wjgs.v15.i8.1825.

Abstract

BACKGROUND

Embryonic hepatic artery anatomy simplifies its identification during liver transplantation. Injuries to the donor hepatic artery can cause complications in this process. The hepatic artery's complex anatomy in adults makes this step challenging; however, during embryonic development, the artery and its branches have a simpler relationship. By restoring the embryonic hepatic artery anatomy, surgeons can reduce the risk of damage and increase the procedure's success rate. This approach can lead to improved patient outcomes and lower complication rates.

CASE SUMMARY

In this study, we report a case of donor liver preparation using a donor hepatic artery preparation based on human embryology. During the preparation of the hepatic artery, we restored the anatomy of the celiac trunk, superior mesenteric artery, and their branches to the state of the embryo at 5 wk. This allowed us to dissect the variant hepatic artery from the superior mesenteric artery and left gastric artery during the operation. After implanting the donor liver into the recipient, we observed normal blood flow in the donor hepatic artery, main hepatic artery, and variant hepatic artery, without any leakage.

CONCLUSION

Donor hepatic artery preparation based on human embryology can help reduce the incidence of donor hepatic artery injuries during liver transplantation.

摘要

背景

胚胎期肝动脉解剖结构使肝移植过程中其识别更为简便。供体肝动脉损伤可在此过程中引发并发症。成人肝动脉复杂的解剖结构使这一步骤具有挑战性;然而,在胚胎发育过程中,该动脉及其分支的关系更为简单。通过恢复胚胎期肝动脉解剖结构,外科医生可降低损伤风险并提高手术成功率。这种方法可改善患者预后并降低并发症发生率。

病例总结

在本研究中,我们报告了一例基于人类胚胎学进行供体肝动脉准备的供肝制备病例。在肝动脉准备过程中,我们将腹腔干、肠系膜上动脉及其分支的解剖结构恢复至胚胎5周时的状态。这使我们能够在手术过程中从肠系膜上动脉和胃左动脉分离出变异肝动脉。将供肝植入受体后,我们观察到供体肝动脉、肝总动脉和变异肝动脉血流正常,无任何渗漏。

结论

基于人类胚胎学的供体肝动脉准备有助于降低肝移植过程中供体肝动脉损伤的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2f6/10494588/2fa795f21da2/WJGS-15-1825-g001.jpg

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