摘要
目的探讨腹腔镜辅助全肝移植的应用价值。方法采用回顾性描述性研究方法。收集2024年1—4月广西壮族自治区人民医院收治的9对行腹腔镜辅助全肝移植供者和受者的临床资料;供者男8例,女1例;年龄为(39±18)岁,体质量指数为(20±4)kg/m^(2);受者男7例,女2例;年龄为(41±13)岁,BMI为(24±4)kg/m^(2)。正态分布的计量资料以x±s表示。计数资料以绝对数表示。结果(1)手术情况。9例受者中,7例顺利完成腹腔镜辅助全肝移植,1例受者因严重门静脉高压症导致腹腔镜下完成肝周游离后解剖第一肝门时大出血,中转开腹作反“L”型切口后完成肝移植,另1例受者供肝置入腹腔时因操作空间不足,腹部切口改为经绕脐延长切口后完成腹腔镜辅助供肝置入。7例顺利完成腹腔镜辅助全肝移植受者总手术时间为(648±31)min,无肝期时间为(57±5)min,术中出血量为(1322±627)mL,供肝质量为(1195±232)g,供肝质量与受者体质量比为1.86%±0.42%。8例受者术中完成腹腔镜下肝周游离及肝门解剖的操作时间为(212±35)min。(2)术后情况。9例受者术后均顺利恢复,无血管、胆管相关并发症发生,手术切口恢复良好。7例顺利完成腹腔镜辅助全肝移植受者术后住院时间为(14.2±2.0)d。(3)随访情况。9例受者均完成术后3个月随访,无血管、胆管相关并发症发生。结论腹腔镜辅助全肝移植可应用于满足手术条件的受者并取得较好的短期临床疗效。
Objective To investigate the application value of laparoscopic-assisted total liver transplantation.Methods The retrospective and descriptive study was conducted.The clinical data of 9 pairs of donors and recipients who underwent laparoscopic-assisted total liver transplanta-tion in People′s Hospital of Guangxi Zhuang Autonomous Region from January to April 2024 were collected.Of the donors,there were 8 males and 1 female,aged(39±18)years and with body mass index(BMI)of(20±4)kg/m^(2).Of the recipients,there were 7 males and 2 females,aged(41±13)years and with BMI of(24±4)kg/m^(2).Measurement data with normal distribution were represented as Mean±SD.Count data were described as absolute numbers.Results(1)Surgical conditions.Of the 9 recipients,7 recipients underwent laparoscopic-assisted total liver transplantation successfully,1 recipient with severe portal hypertension converted to open surgery with reverse L-shaped incision due to the hemorrhage during the dissection of the first hepatic portal after completing liver mobilization under laparoscopy,and 1 recipient underwent trans-umbilical extension incision through the middle of the epigastric region due to the limited space for operation in the implantation of the donor liver.The total operation time for 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was(648±31)minutes,with a time of anhepatic phase of(57±5)minutes,the volume of intraoperative blood loss of(1322±627)mL,the donor liver mass of(1195±232)g,and the ratio of donor liver mass to recipient body mass of 1.86%±0.42%.The operation time for laparoscopic liver dissection and porta hepatis dissection in 8 recipients during surgery was(212±35)minutes.(2)Postoperative conditions.All 9 recipients recovered smoothly after surgery,without any vascular or biliary related complications,and the surgical incision recovered well.The duration of postoperative hospital stay of 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was(14.2±2.0)days.(3)Follow-up.All 9 recipients were followed up for 3 months after surgery.During the follow-up period,there was no vascular or bile duct related complication.Conclusion Laparoscopic-assisted total liver transplantation can be applied to recipients who meet surgical conditions and achieve good short-term clinical efficacy.
作者
庞飞雄
黄晓春
刘洪君
李川
徐钰驹
邓永恒
张映周
农翔
欧升淞
李甲志
何俊鑫
蒋佳君
沈扬林
韦小娇
黄景珠
赖彦华
Pang Feixiong;Huang Xiaochun;Liu Hongjun;Li Chuan;Xu Yuju;Deng Yongheng;Zhang Yingzhou;Nong Xiang;Ou Shengsong;Li Jiazhi;He Junxin;Jiang Jiajun;Shen Yanglin;Wei Xiaojiao;Huang Jingzhu;Lai Yanhua(Department of Transplantation,People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning530021,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2024年第11期1445-1451,共7页
Chinese Journal of Digestive Surgery
基金
广西科技计划项目(桂科AD22035101)
广西卫健委重点实验室(ZZH2020006)。
关键词
肝移植
外科手术
微创性
腹腔镜辅助
安全性
可行性
疗效
Liver transplantation
Surgical procedures,minimally invasive
Laparoscopic-assisted
Safety
Feasibility
Efficacy
作者简介
通信作者:赖彦华,Email:1379771812@qq.com。
