Lin P J, Jeng L B, Chen R J, Kao C L, Chu J L, Chang C H
Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Int Surg. 1993 Oct-Dec;78(4):295-7.
The heparinized-coated tube is widely used for arterial bypass, mainly in patients with aneurysms or trauma of the thoracic aorta. Its application in venous bypass was less frequent. We report a 26-year-old woman who sustained blunt abdominal injury which resulted in complete severance of the suprahepatic hepatic vein and multiple partial lacerations of the inferior vena cava. For hemostasis, total hepatectomy with interruption of the inferior vena cava was performed. During the anhepatic phase, end-to-end portocaval anastomosis and a bypass shunt using 9 mm Gott tube from the right femoral vein to the right atrium were set up for veno-venous bypass. Orthotopic liver transplantation was performed later. Gott tube was placed for 18 hours with good venous return. We concluded that heparinized-coated tube is good for veno-venous bypass with the following advantages: 1) simple operative procedure, 2) enough flexibility to be kept out of the operative field, 3) no anticoagulant is necessary, consequently less bleeding resulted.
肝素涂层管广泛应用于动脉搭桥手术，主要用于患有动脉瘤或胸主动脉创伤的患者。其在静脉搭桥手术中的应用较少。我们报告了一名26岁女性，她遭受钝性腹部损伤，导致肝上肝静脉完全离断和下腔静脉多处部分撕裂伤。为了止血，进行了全肝切除并中断下腔静脉。在无肝期，建立了端到端门腔静脉吻合术，并使用9毫米戈特管从右股静脉至右心房进行旁路分流以进行静脉-静脉旁路。随后进行了原位肝移植。戈特管放置了18小时，静脉回流良好。我们得出结论，肝素涂层管有利于静脉-静脉旁路，具有以下优点：1）手术操作简单；2）足够灵活，可置于手术视野之外；3）无需抗凝剂，因此出血较少。
