Colomb K, Mizrahi S, Downes T, Hayes D H, Hussey J L, Boudreaux J P
Department of Surgery, Ochsner Clinic, New Orleans, LA 70121.
Transpl Int. 1993 May;6(3):158-60. doi: 10.1007/BF00336360.
Situs inversus has been considered an absolute contraindication to liver transplantation due to technical difficulties. Associated vascular malformation and distorted anatomy may make the procedure even more complicated or impossible. Only three cases of patients with abdominal situs inversus who underwent successful liver transplantation have been reported in the English literature. We describe two additional patients with situs inversus who suffered from biliary atresia and underwent successful liver transplantation. The preoperative evaluation and the operative procedure are presented, and technical difficulties are discussed. Since biliary atresia is associated with polysplenia syndrome, including vascular malformation and visceral malposition, we suggest that each case be extensively evaluated preoperatively to determine the size requirement for the donor liver and the feasibility of reconstruction.
由于技术困难，内脏反位一直被认为是肝移植的绝对禁忌证。相关的血管畸形和解剖结构扭曲可能使手术更加复杂甚至无法进行。英文文献中仅报道了3例内脏反位患者成功进行肝移植的病例。我们描述了另外2例患有胆道闭锁的内脏反位患者，他们成功接受了肝移植。介绍了术前评估和手术过程，并讨论了技术难点。由于胆道闭锁与多脾综合征相关，包括血管畸形和内脏异位，我们建议对每例患者进行广泛的术前评估，以确定供肝的大小要求和重建的可行性。
