Effect of devascularization and shunt on liver transplantation in patients with portal hypertension
10.3969/j.issn.1674-7445.2016.05.009
- VernacularTitle:门静脉高压症患者行断流术和分流术对肝移植的影响
- Author:
Wei MENG
1
;
Hui ZHAO
;
Tong ZHANG
;
Binsheng FU
;
Guoying WANG
;
Shuhong YI
;
Chi XU
;
Genshu WANG
;
Hua LI
;
Yang YANG
;
Guihua CHEN
Author Information
1. 中山大学附属第三医院器官移植中心
- Keywords:
Liver transplantation;
Portal hypertension;
Devascularization;
Shunt
- From:
Organ Transplantation
2016;7(5):378-381
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the influence of devascularization and shunt on liver transplantation in patients diagnosed with portal hypertension. Methods Clinical data of 182 patients diagnosed with cirrhosis,portal hypertension complicated with hemorrhages caused by esophageal and gastric varices rupture undergoing liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from January 2007 to December 201 1 were retrospectively analyzed. Nineteen patients undergoing splenectomy plus pericardial devascularization were assigned into the devascularization group,5 receiving distal spleen-renal vein shunt into the shunt group,and the remaining 158 cases with no history of devascularization or shunt into the control group. Preoperative incidence of pylethrombosis,operation time,intraoperative hemorrhage volume,the maximal blood flow velocity (Vmax )of portal vein anastomotic stoma at postoperative 1 month,postoperative incidence of pylethrombosis and 3-year survival rate were statistically compared among three groups. Results In the devascularization group,preoperative incidence of pylethrombosis was significantly higher compared with that in the control group(P<0.01).Compared with the control group,operation time of liver transplantation in the devascularization and shunt groups was significantly longer (both P<0.05 ). The incidence of pylethrombosis at postoperative 1 month was considerably enhanced in the devascularization group (P <0.05 ). The 3-year survival rates of devascularization group and shunt group were dramatically decreased compared with that of control group (both P<0.05 ). Intraoperative hemorrhage volume and Vmax of portal vein anastomotic stoma did not significantly differ among three groups (all P>0.05 ). Conclusions The medical history of devascularization or shunt will not cause severe difficulty or surgical risk to subsequent liver transplantation in patients with portal hypertension.
