大网膜袖套法在背驮式肝移植中的应用

目的：探讨背驮式肝移植中应用带蒂大网膜袖套法预防和治疗胆漏的方法及临床应用价值。方法：回顾性分析我院18例背驮式肝移植病人应用带蒂大网膜袖套法包绕胆总管吻合口的临床资料。结果：14例因存在肝移植术后胆漏的高危因素而在术中应用此方法，其中1例于术后第8天出现胆漏，经充分引流后痊愈，其他13例未出现任何胆道并发症；另4例因背驮式肝移植术后出现胆漏、内科治疗无效而行胆总管再次吻合时应用此方法．术后痊愈出院。结论：带蒂大网膜袖套法操作简单、创伤小，可有效预防和治疗背驮式肝移植术后胆漏。

Application of pedicled omentum in piggyback liver transplantation

Objective To investigate the clinical value of pedicled omentum to prevent and manage biliary leakage following piggyback liver transplantation.Methods The clinical data of 18 cases of piggyback liver transplantation(PBLT) which used the pedicled omentum to wrap the anastomosis of the biliary tract were retrospectively analyzed.Results Fourteen patients with high risk of developing biliary leakage used this method during the PBLT operation.Among them,only 1 patient developed biliary leakage on the postoperative day 8.The other 4 patients developed biliary leakage after PBLT and underwent secondary bile duct reconstruction;pedicled omentum was then used to wrap the anastomosis of the biliary tract;and the patients recovered.Conclusions Pedicled omentum is a new technique to prevent and treat biliary leakage after liver transplantation;and it decreases the biliary complications as well.