| 摘要: |
| 目的：应用原位肝移植治疗1例内脏全反位肝癌患者,并探讨术后并发症的处理方法。方法：将正常解剖的供肝绕中线顺时针垂直旋转90°植入患者原位,所有管道吻合口均采取端-端吻合的方法,患者术后随访并积极处理并发症。结果：患者术后恢复良好,5个月出现胆管吻合口狭窄,经内镜下逆行胆管内支架引流(ERBD)和经皮肝穿刺胆管引流(PTCD)治疗后痊愈。随访30个月,移植肝功能正常,肿瘤无复发。结论：内脏全反位肝癌患者可实施原位肝移植治疗,胆道并发症是其主要并发症之一,经过及时处理可获得良好的长期预后。 |
| 关键词: 左右转位 肝移植 并发症 |
| DOI：10.3724/SP.J.1008.2008.00606 |
| 投稿时间：2008-03-04修订日期：2008-04-17 |
| 基金项目:上海市科委科研重大课题(024119001). |
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| Liver transplantation for a hepatic cancer patient with complete situs inversus and management of complications |
| YANG Ning△,LU Jun-hua△,ZHANG Hai-bin,SI Ma-hui,SHAO Zhuo,YANG Guang-shun* |
| (Department of 2nd Biliary Tract Surgery,Eastern Hepatobiliary Hospital,Second Military Medical University,Shanghai 200438,China) |
| Abstract: |
| Objective:To explore the surgical techniques of liver transplantation(LT)for a hepatic cancer patient with complete situs inversus (CSI) and to discuss the post-operation management of complications.Methods: A patient with CSI suffering from hepatocelluar carcinoma underwent LT in June 2005.LT was performed orthotopically using the clockwise 90° rotation technique with all vessels end-to-end anastomized.The post-operation complications were actively managed and the patient was followed up.Results: Post-operatively,the patient recovered well without major complications,except for a bile duct anastomotic stenosis during the 5th post-operative month,which was dealt with endoscopic retrograde biliary drainage and percutaneous transhepatic cholangial drainage.Liver function was stable and no tumor recurrence was found during a follow-up period of 30 months.Conclusion: It is feasible to perform LT in patients with CSI.Bile duct anastomotic stenosis is one of the most important complications after LT,which can have a good long-term prognosis if promptly managed. |
| Key words: situs inversus liver transplantation complication |
