40例临床肝移植血管和胆管重建经验

目的：总结第三军医大学西南医院肝移植时血管及胆管重建的经验。方法：回顾性分析40例肝移植时血管重建，胆道重建的方法及效果。结果：本研究肝移植病例围手术期死亡6例，手术病死率为15．0％，并发症为：肺部感染18例，多器官功能衰竭5例；腹腔内出血4例：ARDS8例；肝动脉血栓形成1例，胆漏1例，脑出血1例，存最长的1例为31个月，有15例生存期超过1年。结论：良好的血管和胆管重建技术是确保肝移植手术成功的关键。

Experience of vascular and bile duct reconstruction in 40 cases of orthotopic liver transplantation

Objective To summarize the vascular and bile duct reconstruction experience in 40 cases of orthotopic liver transplantation in the southwest hepatobiliary surgery hospital. Methods The clinical data of 40 cases of liver transplantation were analyzed retrospectively from Jan. 1999 to Nov. 2001. Results Mortality rate of this group was 15.0%. Complications included: pulmonary infection (18 cases), MOSF (5 cases), intraperitoneal bleeding (4 cases), ARDS (8 cases), thrombus of hepatic artery (1 case), bile leakage (1 case), and cerebral hemorrhage (1 case). The longest survival time was 31 moths (1 case). There were 15 cases whose survival time was more than 1 year. Conclusions The key point of success of liver transplantation relies on excellent vascular and bile duct reconstruction technique.