活着的捐赠者左肝切除术作为极度严重胆汁泄漏需要非保守治疗的危险因素:回顾性分析
Masashi Kadohisa1, Yukihiro Inomata, Tomoaki Irie
1From the Department of Transplantation and Pediatric Surgery, Kumamoto University, Kumamoto, Japan and the Department of Hepatobiliary Pancreatic and Transplantation/Pediatric Surgery, Kyoto University, Kyoto, Japan.
概括
活体捐赠者肝移植捐赠者在手术后可能会出现严重的胆汁泄漏. 左肝切除术带来极度严重胆汁泄漏的风险更高,需要仔细的手术规划.
科学领域:
- 肝胆道手术 肝胆道手术
- 移植手术 移植手术
- 手术并发症 手术并发症
背景情况:
- 在活体捐赠者肝移植中,捐赠者安全至关重要.
- 手术后胆汁泄漏是活体捐献者的已知并发症.
- 严重的胆汁泄漏 (Clavien-Dindo ≥IIIa级) 需要进行特定的评估.
研究的目的:
- 为了评估活体捐献者的严重胆汁泄漏的特征.
- 为了确定与肝切除术后严重胆汁泄漏相关的危险因素.
- 分析不同类型肝切除术对胆汁泄漏严重性的结果.
主要方法:
- 对453名活体捐赠者肝移植捐赠者的回顾性审查.
- 从2000年8月到2017年3月在熊本大学医院收集的数据.
- 对供体肝切除术的分析,包括右,左和左侧细分切除术.
主要成果:
- 严重胆汁泄漏的总发病率为4.6%.
- 肝切除类型之间胆汁泄漏发生率没有显著差异.
- 极度严重的胆汁泄漏发生在左肝切除术 (n=6) 后.
结论:
- 左肝切除术是极度严重胆汁泄漏的潜在危险因素.
- 术前胆道解剖学的评估对于降低风险至关重要.
- 在状板附近仔细切割膜切割对于供体安全至关重要.
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