大鼠原位肝移植模型的手术操作技巧探讨

目的 建立一个稳定的大鼠原位肝移植模型，探讨其手术技巧。方法在Kamada“二袖套法”的基础上进行改良。供体改经腹主动脉进行肝脏冷灌注；肝上下腔静脉用连续缝合法吻合，门静脉和肝下下腔静脉用袖套法吻合．胆总管采用单管内支架胆管端端吻合法。结果共施行大鼠原位肝移植140例，无肝期平均11min．手术成功率为97％,大鼠1周存活率为95％。结论改良的两袖套法具有操作简便、无肝期短、手术成功率高、大鼠术后存活时间长的优点，是大鼠原位肝移植的理想术式。娴熟细致的外科操作、受体无肝期的长短是决定动物存活的关键。     

120例大鼠原位肝移植报道

目的建立一个稳定的大鼠原位肝移植模型,探讨其术中和术后并发症的预防。方法在Ka-mada“二袖套法”吻合血管的基础上进行改良。供体改经腹主动脉进行肝脏冷灌注;肝上下腔静脉用缝合法吻合,门静脉和肝下下腔静脉用袖套法吻合,胆总管采用单管内支架胆管端端吻合法。结果共施行大鼠原位肝移植120例,手术成功率为96.7%。大鼠1周存活率为95%,3月存活率达90%。结论娴熟细致的外科操作提高了手术成功率,受体无肝期的长短是决定动物存活的关键。     

大鼠原位肝移植术近期并发症的预防

目的 :探讨如何预防大鼠原位肝移植术的近期并发症。方法 :在Kamada等用袖套法吻合血管的基础上 ,进行改进 ,供体改经腹主动脉进行肝脏冷灌注 ,肝上下腔静脉用缝合法吻合 ,门静脉和肝下下腔静脉用袖套法吻合 ,胆总管采用单管内支架胆管端端吻合法 ,共施行大鼠原位肝移植术 36 0次 ,供体手术时间为(31.2± 5 )min ,受体手术时间为 (4 5± 5 .5 )min ,无肝期为 (2 0± 2 .5 )min。结果 :术后近期主要并发症有 :出血12例 ,肝下下腔静脉血栓 8例 ,袖套扭转或脱落 4例 ,胆管梗阻 3例。结论 :娴熟的显微外科技术、细致的手术操作是预防术中和术后并发症的先决条件。受体无肝期的长短是决定动物存活的关键。     

大鼠原位肝移植模型的建立及术式改进

目的探讨用双袖套法建立大鼠原位肝移植模型的手术改进方法. 方法在Kamada等的袖套法吻合血管的基础上进行改进,供体改经腹主动脉进行肝脏冷灌注,肝上下腔静脉用缝合法吻合,门静脉和肝下下腔静脉用袖套法吻合,胆总管采用单管内支架胆管端端吻合下进行原位肝移植360例(次). 结果施行大鼠原位肝移植其供体手术时间(31.2±5.0)分钟,供肝修整时间(12.0±3.0)分钟,受体手术时间(45.0±5.5)分钟,无肝期(20.0±2.5)分钟,手术死亡31例,其中出血12例,肝下下腔静脉血栓8例,肝上下腔静脉回流不畅7例,袖套扭转或脱落4例.术后成活2天以上329例,成活率为91.4%.非干预组(非药物治疗组)1周存活率达86.5%. 结论改进的大鼠原位肝移植术操作简便,手术成功率高,可作为肝移植实验可靠、稳定的动物模型.     

改进的二袖套法大鼠原位肝移植术

目的 制作改进的二袖套法大鼠原位肝移植模型。方法 在原二袖套法的基础上，于受者门静脉和肝下下腔静脉吻合前放出部分高凝血液，而肝上下腔静脉的吻合是在供肝膈肌环与受者肝上下腔静脉血管壁之间进行。结果 改进的二袖套法吻合效果确实可靠，手术成功率达96．7％，动物的1周存活率为90．0％。结论 该模型稳定可靠，可用于大鼠肝移植方面的研究。     

大鼠原位肝移植胆道并发症的原因分析

目的研究胆道并发症的发生原因,建立稳定的大鼠原位肝移植模型。方法“二袖套法”行大鼠原位肝脏移植180例,即肝上下腔静脉（SVC）采用连续缝合法吻合,门静脉（PV）以及肝下下腔静脉（IVC）采用袖套法吻合,胆总管采用内支架胆管端端吻合法。结果模型稳定后,供肝冷缺血时间为（50．1±12．0）min,无肝期为（16．0±3．1）min,受体手术时间为（54．4±10．6）min,术后胆道并发症的发生率为40％,主要表现为肝脓肿、肝内外胆管扩张、胆泥形成等。结论胆管内支架管的选择以及手术技巧是影响大鼠肝移植术后胆道并发症发生发展的重要因素。     

经升主动脉灌注的无心跳供体大鼠原位肝移植模型的建立

目的 探讨建立一个能灌注更彻底、更易操作、热缺血时间容易控制的原位肝移植动物模型。方法 在Kamada两袖套法的基础上进行改良，供体经升主动脉进行冷灌注，肝上下腔静脉用缝合法吻合，门静脉和肝下下腔静脉用袖套法吻合，胆总管采用胆管内支架端端吻合的方法。建立无心跳供体的大鼠原位肝移植模型。结果 40例移植后1d大鼠存活率为95．0％(38／40)，1周存活率为85．5％(35／40)。结论 经升主动脉灌注的供肝灌注更彻底、均匀，更易操作，热缺血时间控制更精准，行肝移植后1周存活率较文献报道高。     

“二袖套法”制备大鼠原位肝移植模型的方法改进

目的 在Kamada“二袖套法”的基础上对大鼠肝移植手术方法进行改进，提高大鼠肝移植模型的稳定性和动物存活率。方法在Kamada“二袖套法”大鼠肝移植基础上对供肝切取、受体手术及术中管理进行改进行大鼠肝移植60例，Kamada“二袖套法”行大鼠肝移植20例。比较两组大鼠肝移植术后并发症的发生率和1周生存率。结果在Kamada“二袖套法”基础上改进的肝移植大鼠并发症发生率较少，1周存活率91．7％，经典Kamada“二袖套法”肝移植大鼠1周存活率70％。结论改进的大鼠原位肝移植术操作简便，手术成功率高，模型稳定性好。     

三袖套法金黄地鼠至大鼠肝移植模型术式改进及并发症预防措施

目的；探讨大鼠原位肝移植法模型的术式改进方法及其并发症的预防措施。方法：应用改良Ｈａｒｉｌａｒａ氏三袖套法－用袖套法吻合肝上下腔静脉（ＳＶＣ），肝下下腔静脉（ＩＶＣ）及门静脉（ＰＶ），应用塑料胆汁引汉支架行胆总管（ＢＤ）或胆囊胆总管吻合法重建胆道连续性，建立金黄地鼠至大鼠原位肝移植模型，结果：成功施行金黄地鼠至大鼠原位肝移植术２１例，其中供肝手术３６例，供体手术，血管袖套准备及受体手术时间分别为５     

二袖套法大鼠原位肝移植手术方法的改进

目的：通过对二袖套法大鼠原位肝移植手术方法进行改进，提高大鼠肝移植动物模型的稳定性。方法：采用改良的二袖套法施行大鼠原位肝移植动物实验110例，观察术后并发症及24h、一周存活率。结果：袖套准备时间5—9min，24h存活率91．8％(101／110)，一周存活率为87．3％(96／110)。结论:改进的大鼠原位肝移植术操作简便，手术成功率高，重复性好，提高了大鼠肝移植动物模型的稳定性。     

改良"二袖套法"大鼠原位肝移植及早期并发症预防

目的研究大鼠原位肝移植模型的手术技巧及术后并发症的预防及处理。方法采用改良"二袖套法"建立大鼠原位肝移植模型,其中供体、受体各160只。结果在肝移植初期共行手术120对,48 h存活率为46.7%。后期手术40对,48 h存活率95.0%。结论适量的麻醉、熟练的供肝游离灌洗和修整技术以及精细的显微外科技术操作是大鼠原位肝移植的关键。     

改良"二袖套法"制备大鼠原位肝移植动物模型

目的：介绍改进的“二袖套法”法大鼠原位肝移植动物模型。方法：采用改进的“二袖套”法进行110只大鼠原位肝移植。结果：切取供肝时间平均37min，修肝时间平均13min，无肝期平均14min，术中和术后4h内死亡8只，手术成功率达93%。术后1周死亡11只，1周存活率为89%，主要死亡原因为感染和胆道梗阻。结论：改进的“二袖套”法大鼠原位肝移植具有无肝期短、手术成功率高，大鼠术后存活时间长的优点，是大鼠原位肝移植的理想术式。     

"二袖套法"制备大鼠原位肝移植模型的方法改进

目的在Kamada "二袖套法"的基础上对大鼠肝移植手术方法进行改进,提高大鼠肝移植模型的稳定性和动物存活率.方法在Kamada"二袖套法"大鼠肝移植基础上对供肝切取、受体手术及术中管理进行改进行大鼠肝移植60例,Kamada"二袖套法"行大鼠肝移植20例.比较两组大鼠肝移植术后并发症的发生率和1周生存率.结果在Kamada"二袖套法"基础上改进的肝移植大鼠并发症发生率较少,1周存活率91.7%,经典Kamada"二袖套法"肝移植大鼠1周存活率70%.结论改进的大鼠原位肝移植术操作简便,手术成功率高,模型稳定性好.     

Novel technique for suprahepatic vena cava reconstruction in rat orthotopic liver transplantation

In previous studies, the suture technique and the cuff method were applied to anastomoses of the suprahepatic vena cava (SHVC) in rat orthotopic liver transplantation. However, the anastomosis of SHVC is difficult during transplantation because of the short length of the SHVC. Here, we developed a novel method for anastomoses of SHVC, using a veno-lined stent technique. The veno-lined stent for SHVC anastomosis was prepared after the donor operation. The special veno-lined stent was a 4.0-mm-long polythene tube in which a venous segment from the donor was lined. During the recipient operation, the donor SHVC was anastomosed end-to-end to the recipient SHVC, using the veno-lined stent. Anastomoses of the portal vein and infrahepatic vena cava were performed using a cuff technique. Continuity of the bile duct was established using a stent. The hepatic artery was ligated, and the graft was not arterialized. As controls, the unlined stent, the suture technique, and the cuff method were also used for SHVC anastomoses, respectively, as three control groups with the identical procedures above. In total, 30 orthotopic liver isografts were performed using the veno-lined stent technique. The survival rate was 90% (27/30) after 1 week and 70% (21/30) after 2 months, with normal hepatocellular function. The SHVC anastomosis using a veno-lined stent took 10 +/- 2 (mean +/- SD) min. The anhepatic phase, recipient operative time, and complete operation time were about 14 +/- 2 min, 40 +/- 5 min, and 120 +/- 10 min, respectively. However, in the nonlined stent control group, a total of 20 orthotopic liver isografts used the nonlined stent for SHVC anastomoses, and all failed because of venous thrombosis in SHVC; none survived over 1 week. In the suture technique control group, 40 orthotopic liver isografts were performed using a suture technique for SHVC anastomoses. The results showed no significant difference with those of the veno-lined stent method. But in the cuff method control group, of all 20 orthotopic liver isografts performed using the cuff method for SHVC anastomoses, 10 failed because of failed ligation on the anastomostic site. The survival rates at 1 week and 2 months postoperatively were significantly different from those of the veno-lined stent method. The veno-lined stent technique provides a novel, simple, and reliable method for SHVC anastomoses. It avoids bleeding during suture and the ligation difficulties found with the cuff method. The operation's success rate is satisfactory. This model is successful, and could be applied in various experimental studies.     

大鼠原位肝移植胆道外引流模型的建立

目的 建立一个稳定的大鼠原位肝移植胆道外引流模型,为研究移植术后胆汁中的成分,细胞学及免疫学指标提供可能。方法 在Ｋａｍａｄａ方法的基础上,加以技术改进,肝上下腔静脉采用端端吻合法,门静脉及肝下下腔静脉采取袖套法吻合,胆总管内置引流管引至大鼠颈背部,外接引流袋。结果 共施行大鼠原位肝移植７５次,２４ｈ动物存活率这９３．３％,１周动物存活为８６．６％,结论 该模型是研究肝移植术后胆汁成分,胆汁细胞学     

Simplified rat lung transplantation by using a modified cuff technique

Mizuta's cuff technique in rat lung transplantation (LT) model has some disadvantages, such as twisting of blood vessels or bronchus and being time-consuming, which complicate procedures for anastomosis. This study was performed to investigate the advantage of using a simplified cuff technique in LT. The anastomosis time was compared in two groups. In group I, Mizuta'scuff technique was performed in 50 rat orthotopic left lung transplants. In group II, a simple modified cuff technique was performed in 48 rat orthotopic left lung transplants. The successful rate of the new technique for anastomosis was 100%. No twist of vessels or bronchus and no bleeding or air leakage were observed in group II. The anastomosis time of group II was significantly less than for group I (11.2 +/- 2.1 min vs. 18.1 +/- 3.6 min, mean +/- SD, p < .01). This simple modified cuff technique led to less anastomosis time and avoided potential complications induced by the cuff-tail technique. It has been verified to be a safe, simple, and reproducible technique that can provide us with a more precise assessment in the rat LT model.