http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 주제어 : Hepatic artery reconstruction (검색결과 3 건)
- 무료
- 기관 내 무료
- 유료
-
간이식에 있어서 간동맥 재건을 위한 미세혈관수술교육의 효과
허위광(Weiguang Xu),김봉완(Bong-Wan Kim),배병구(Byong-Ku Bae),왕희정(Hee-Jung Wang),김명욱(Myung-Wook Kim) 한국간담췌외과학회 2010 한국간담췌외과학회지 Vol.14 No.1
Purpose: During liver transplantation (LT), complications of the hepatic artery have been decreased because of microsurgery in reconstruction of hepatic artery has been widely adopted. However, in an early step of the LT program, hepatic artery reconstruction generally tends to be done with the help of a micro-surgeon from the the plastic surgery in most of Korean medical centers. In our center, we also have done reconstruction of the hepatic artery using a microscope and the skills of a plastic surgeon. We did this between Feb, 2005 and Jun, 2008 for liver transplantations. The increased the need for micro-surgeons in liver surgery as increased the cases of liver transplantation steadily. After training general surgeons of the surgical department who had no experience with microsurgery, we invested in the micro-surgery of hepatic artery reconstruction. Here we report the result of that investment. Methods: Liver transplant patients (n=176) were enrolled between Feb, 2005 and Jul, 2009. Between Jul, 2008 and Jul, 2009, 28 cases of reconstruction of the hepatic artery were done by a general surgeon who had micro-surgery training. Before training in hepatic artery reconstruction, the general surgeon spent 3 months being introduced to micro-surgery in the micro animal laboratory. Because the training was repeated, the surgeon became skilled in doing artery anastomosis using rat’s abdominal aorta. At the same time, we trained a plastic surgeon to do hepatic artery reconstruction during liver transplantation as the first assistant. From Jul, 2008 to the present time, the general surgeon was exclusively in charge of hepatic artery reconstruction during liver transplantation. Hepatic artery reconstruction was done using a microscope. Stitching was done using 8-0 or 9-0 nylon, and an interrupted end-to-end anastomosis was done. After hepatic artery reconstruction, artery flow was confirmed by ultrasonic doppler. For group A patients, left lobe grafts were used in 33, right lobe grafts in 73, dual grafts in 6, and whole liver grafts in 36. Results: For group B patients, left lobe grafts were used in 1 and right lobe grafts in 21, while whole liver grafts were used in 6. In Group A, hepatic artery complications occurred in 5 cases (3.3%), and in Group B such complications did not occur (0%). There was no statistical difference (p=0.312). Conclusion: For hepatic artery reconstruction, during micro-surgery under a surgical microscope, it is thought that it is best to invest in a general surgeon who has been trained in micro-surgery. We suggest that a general surgeon is suitable for hepatic artery reconstruction after only a short time of micro surgery training.
-
Choi Jin Uk,Hwang Shin,Ahn Chul-Soo,Moon Deok-Bog,Park Gil-Chun 대한이식학회 2021 Korean Journal of Transplantation Vol.35 No.4
Hepatic artery thrombosis (HAT) following living donor liver transplantation (LDLT) is a lethal complication. We present the case of a patient who underwent salvage redo hepatic artery reconstruction using an aorto-hepatic jump graft because of HAT following LDLT. A 64-year-old female patient diagnosed with hepatitis C virus-associated liver cirrhosis and hepatocellular carcinoma underwent salvage LDLT using a modified right liver graft. Partial graft infarct was identified at posttransplant day 4, and by day 9, it had spread. Celiac arteriography showed complete occlusion of the graft hepatic artery. We performed redo hepatic artery reconstruction using a fresh iliofemoral artery homograft 10 days after the LDLT operation because such a vessel homograft was available at our institutional tissue bank. The infrarenal aorta was dissected and an iliofemoral artery graft was anastomosed. Soon after hepatic artery revascularization, liver function progressively improved, and the infarct area at the liver graft was reduced. The patient has been doing well for 10 years without any vascular complications. In conclusion, our experience with this case suggests that salvage redo hepatic artery reconstruction using an aorto-hepatic jump graft is a feasible option to treat HAT following LDLT, as in deceased donor liver transplantation.
-
연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
