原位肝移植肝动脉和门静脉的重建

目的：总结同种异体原位肝移植术中肝动脉和门静脉吻合的经验。方法：回顾性分析9例原住肝移植术中影响肝动脉和门静脉吻合的因素和处理技巧。结果：5例行供、受者肝固有动脉端端吻合，2例供者肝总动脉与受者肝固有动脉吻合，2例供者肝总动脉与受者脾动脉吻合；8例采用门静脉端端吻合，1例因受者门静脉主干长段闭塞，取栓无法再通，将供肝门静脉与受省下腔静脉吻合。术后彩色多普勒超声监测显示动脉和门静脉血流通畅，均未发现有血栓形成或狭窄，现存活6例。结论：合理选择吻合用血管是避免术后发生血栓形成和狭窄的关键。

RECONSTRUCTION OF LIVER ARTERY AND PORTAL VEIN IN ORTHOTOPIC LIVER TRANSPLANTATION

Objective:To investigate the experience of vascular inosculation between liver artery and portal vein in orthotopic liver transplantation.Methods:Facts and skills which affected vascular inosculation between liver artery and portal vein in 9 patients of orthotopic liver transplantation were restrospectively analyzed in this article.Results:The donor and recipient proper liver arteries were reconstructed by end to end anastomcosis in 5 of 9 cases,the donor common liver arteries and the recipient proper liver arteries were reconstructed in 2 of 9 cases,the donor common liver artery was anastomosed to the recipient splenic artery in 2 of 9 cases.The donor and recipient portal vein were reconstructed by end to end anastomcosis in 8 of 9 cases,the donor portal vein and the recipient inferior vena cava were reconstructed in 1 of 9 cases because the recipient portal vein was not patent.All of the anastomosed sites were assessed by Doppler ultrasonography postoperatively,and liver arterial thrombosis or stenosis has not been found.Now 6 patients are alive.Conclusion:Choosing the proper vessel in the vascular reconstruction plays an important role in preventing liver arterial thrombosis and stenosis.