CAJ | 학술논문

目的探讨活体肝移植不同方式供肝切取术后供者康复及肝脏再生情况.方法回顾性分析2006年5月至2011年5月13例活体肝移植供者临床资料.对不同方式供肝切取手术方法、供者术后肝功能指标变化及残肝再生情况进行比较.结果供者手术分为不包含肝中静脉右半肝切除8例,包含肝中静脉右半肝切除2例,左半肝切除3例.供者肝功能及凝血指标均于术后两周恢复正常,术后未见严重并发症,随访情况良好,无供者死亡.术前CT估算供肝体积与术中实际切取供肝重量呈正相关(r＝0.838,P＜0.01).术后复查CT测残肝体积示:右半肝供者残肝较左半肝供者残肝再生速度快,不带肝中静脉右半肝供者较带肝中静脉右半肝供者残肝再生速度略高,但供者肝脏功能恢复无明显差异.结论不同术式活体肝移植供者在规范化围手术期处理、精细手术操作后肝功能均能得到较好的康复,而供肝切取术后残肝再生速度则受切取比例、残肝供血情况、细胞因子调控等多因素影响.
목적 탐토활체간이식불동방식공간절취술후공자강복급간장재생정황.방법 회고성분석2006년5월지2011년5월13례활체간이식공자림상자료.대불동방식공간절취수술방법、공자술후간공능지표변화급잔간재생정황진행비교.결과 공자수술분위불포함간중정맥우반간절제8례,포함간중정맥우반간절제2례,좌반간절제3례.공자간공능급응혈지표균우술후량주회복정상,술후미견엄중병발증,수방정황량호,무공자사망.술전CT고산공간체적여술중실제절취공간중량정정상관(r＝0.838,P＜0.01).술후복사CT측잔간체적시:우반간공자잔간교좌반간공자잔간재생속도쾌,불대간중정맥우반간공자교대간중정맥우반간공자잔간재생속도략고,단공자간장공능회복무명현차이.결론 불동술식활체간이식공자재규범화위수술기처리、정세수술조작후간공능균능득도교호적강복,이공간절취술후잔간재생속도칙수절취비례、잔간공혈정황、세포인자조공등다인소영향.
Objective To study the impact of various donor hepatectomy techniques on clinical rehabilitation and postoperative liver regeneration on living donor liver transplant (LDLT) donors.Methods The data of 13 consecutive LDLT carried out from May 2006 to May 2011,including the surgical techniques,postoperative liver function,and liver regeneration in the donors were retrospectively studied.Results The donor operations included 8 right hepatectomies without the middle hepatic vein,2 right hepatectomies with the middle hepatic vein and 3 left hepatectomies.Hepatic function and blood coagulation function returned to normal within two weeks of hepatectomy in all the donors.There was no severe complication and no death.There was a significant positive correlation between the donor liver volume as measured preoperatively on CT and the resected liver weight as measured intraoperatively (r=0.838,P＜0.01).The volume of the remnant liver increased soon after transplantation.The liver regenerated significantly faster in right than in lefft liver donors.The remnant liver of the right liver donors with middle hepatic vein preservation grew faster than the right liver donors without middle hepatic vein preservation.However,there was no significant difference in the recovery of the liver function between the three groups.Conclusions Donor hepatectomy is safe.The postoperative liver regeneration is affected by multiple factors including the remnant liver volume and blood supply of the remnant liver.