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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.

DOI:10.4240/wjgs.v15.i8.1825
PMID:37701685
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10494588/
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/bac3a2be2c67/WJGS-15-1825-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2f6/10494588/2fa795f21da2/WJGS-15-1825-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2f6/10494588/bac3a2be2c67/WJGS-15-1825-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2f6/10494588/2fa795f21da2/WJGS-15-1825-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2f6/10494588/bac3a2be2c67/WJGS-15-1825-g002.jpg

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本文引用的文献

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Liver transplantation in developing countries.发展中国家的肝移植
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Anatomic Variations of the Hepatic Artery in 5625 Patients.5625例患者肝动脉的解剖变异
Radiol Cardiothorac Imaging. 2021 Aug 19;3(4):e210007. doi: 10.1148/ryct.2021210007. eCollection 2021 Aug.
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Hepatic artery classification based on three-dimensional CT.基于三维CT的肝动脉分类
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Impact of Hepatic Artery Variations and Reconstructions on the Outcome of Orthotopic Liver Transplantation.肝动脉变异与重建对原位肝移植结局的影响。
World J Surg. 2020 Jun;44(6):1954-1965. doi: 10.1007/s00268-020-05406-4.
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Liver Transplantation Today: Where We Are Now and Where We Are Going.肝脏移植的今天:我们现在在哪里,以及我们要去哪里。
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Unusual Variation in the Branching Pattern of the Celiac Trunk and Its Embryological and Clinical Perspective.腹腔干分支模式的异常变异及其胚胎学和临床意义
J Clin Diagn Res. 2016 Jun;10(6):AD05-7. doi: 10.7860/JCDR/2016/19527.8064. Epub 2016 Jun 1.
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Incidence of hepatic artery variations in liver transplantation: does it really influence short- and long-term results?肝移植中肝动脉变异的发生率:它真的会影响短期和长期结果吗?
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