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经腹腔心包路径肝上下腔静脉与右心房吻合肝移植治疗布-加综合征合并肝癌1例附手术视频

叶征辉, 赵红川, 耿小平, 等. 经腹腔心包路径肝上下腔静脉与右心房吻合肝移植治疗布-加综合征合并肝癌1例附手术视频[J]. 器官移植, 2023, 14(6): 855-860. doi: 10.3969/j.issn.1674-7445.2023116
引用本文: 叶征辉, 赵红川, 耿小平, 等. 经腹腔心包路径肝上下腔静脉与右心房吻合肝移植治疗布-加综合征合并肝癌1例附手术视频[J]. 器官移植, 2023, 14(6): 855-860. doi: 10.3969/j.issn.1674-7445.2023116
Ye Zhenghui, Zhao Hongchuan, Geng Xiaoping, et al. Transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium in liver transplantation for Budd-Chiari syndrome complicated with liver cancer: a case report with surgical video[J]. ORGAN TRANSPLANTATION, 2023, 14(6): 855-860. doi: 10.3969/j.issn.1674-7445.2023116
Citation: Ye Zhenghui, Zhao Hongchuan, Geng Xiaoping, et al. Transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium in liver transplantation for Budd-Chiari syndrome complicated with liver cancer: a case report with surgical video[J]. ORGAN TRANSPLANTATION, 2023, 14(6): 855-860. doi: 10.3969/j.issn.1674-7445.2023116

经腹腔心包路径肝上下腔静脉与右心房吻合肝移植治疗布-加综合征合并肝癌1例附手术视频

doi: 10.3969/j.issn.1674-7445.2023116
基金项目: 安徽省临床医学研究转化专项(202204295107020015)
详细信息
    作者简介:
    通讯作者:

    赵红川(ORCID:0009-0008-2266-6352),博士,主任医师,研究方向为器官移植,Email:zhc0117@sina.com

  • 中图分类号: R617, R735.7

Transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium in liver transplantation for Budd-Chiari syndrome complicated with liver cancer: a case report with surgical video

More Information
  • 摘要:   目的  总结经腹腔心包路径供肝肝上下腔静脉与受者右心房吻合肝移植治疗布-加综合征(BCS)合并肝癌的相关经验。  方法  回顾性分析1例经腹腔心包路径肝上下腔静脉与右心房吻合肝移植治疗BCS合并肝癌病例的临床资料。  结果  患者的肝静脉和肝上下腔静脉局部闭塞,在心脏不停跳情况下,采用经腹腔心包路径完成肝上下腔静脉与右心房吻合肝移植,此外,由于受者肝动脉病变,采用受者脾动脉切断,远端结扎,近端反转与供肝肝总动脉吻合,完成肝动脉重建,手术过程顺利。术后1周左右移植肝肝功能逐步恢复正常,无重大并发症发生。患者术后25 d出院,随访8个月余无BCS复发征象。  结论  经腹腔心包路径肝上下腔静脉与右心房吻合肝移植治疗BCS是安全可行的,对于合并肝癌的患者预后较好。

     

  • 图  1  1例BCS患者术前影像学、手术吻合情况及病理学检查结果

    注:A、B图示肝静脉和肝上下腔静脉狭窄,肝右叶肿瘤伴门静脉右支分支癌栓可能(红色箭头所示);C、D图示供肝肝上下腔静脉与受者右心房吻合;E、F图示移植肝恢复血流后的外观及吻合完成的肝动脉、门静脉;G图示切除病肝的外观;H图示病肝病理学检查可见中-低分化肝细胞性肝癌伴出血、坏死(苏木素-伊红染色,×100)。

    Figure  1.  Preoperative imaging, surgical anastomosis and pathological examination results of one BCS patient

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  • 收稿日期:  2023-06-11
  • 网络出版日期:  2023-08-25
  • 刊出日期:  2023-11-09

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