背驮式肝移植肝脏流出道重建方法探讨

目的：总结我院肝移植时肝流出道重建的经验。方法：回顾性分析我院50例肝移植时肝流出道重建方法的改进及效果。结果：本组肝移植病例围手术期死亡8例，围手术期死亡率为16％。本组并发症为：肺部感染32例：多器官功能衰竭2例；腹腔内出血2例；肝动脉血栓形成1例；胆漏2例；无肝脏流出道梗阻。2例生存超过3年，8例生存超过2年，18例生存超过1年。结论：肝流出道重建方法的改进有利于提高肝移植的成功率，减少技术性并发症。

A modified technique for performing hepatic outflow tract reconstruction during liver transplantation

Objectives To explore the value of a modified technique in the reconstruction of the hepatic outflow tract in liver transplantation.Methods From Sep 2002 to Jan 2006,50 cases of liver transplantation were performed.The hepatic outflow tract was reconstructed by a modified technique.Results Eight patients died in the peri-operative period,with an operative mortality of 16%.The major complications included pulmonary infection(32 cases),mnltiple system organ failure(MSOF)(2 cases),intra-peritoneal bleeding(2 cases),hepatic artery thrombosis formation(1 case),and biliary leakage(2 cases).No hepatic outflow tract occlusion occurred in these patients.The numbers of patients survived over 1,2 and 3 years were 18,8 and 2,respectively.Conclusions The innovation of the hepatic outflow reconstruction in liver transplantation helps to improve the surgical outcome and decrease the incidence of technical complications.