Cherqui D, Riff Y, Rotman N, Julien M, Fagniez P L
General and Digestive Surgery Service, Hôpital Henri Mondor, Créteil, France.
Am J Surg. 1994 Mar;167(3):327-30. doi: 10.1016/0002-9610(94)90210-0.
Adequate hepatic arterial reconstruction is essential for successful liver transplantation. In the case of insufficient recipient hepatic arterial flow, most surgeons recommend the use of the aorta for arterialization of the graft. We report here on a technique in which the recipient splenic artery is used in such a setting. The splenic artery is dissected from its origin on a 3-to-4 cm segment and divided. The proximal segment is flipped to the right and anastomosed to the graft's celiac axis in an end-to-end fashion. This technique was used in 7 of 79 orthotopic liver transplantations (9%) because the native hepatic artery was deemed to be inadequate for anastomosis. There were no complications related to the use of this technique and no arterial thromboses. Arterialization of hepatic grafts using the recipient proximal splenic artery is a simple, safe, and efficient technique that can be recommended in the presence of an inadequate recipient hepatic arterial flow.
充足的肝动脉重建对于肝移植成功至关重要。在受体肝动脉血流不足的情况下，大多数外科医生建议使用主动脉进行移植物动脉化。我们在此报告一种在这种情况下使用受体脾动脉的技术。将脾动脉从其起始处游离出3至4厘米的一段并切断。近端段翻转至右侧，以端端方式与移植物的腹腔干吻合。在79例原位肝移植中有7例（9%）使用了该技术，因为认为自体肝动脉不足以进行吻合。使用该技术没有相关并发症，也没有动脉血栓形成。在受体肝动脉血流不足时，使用受体近端脾动脉进行肝移植物动脉化是一种简单、安全且有效的技术，值得推荐。
