Reconstructing the portal vein through a posterior pancreatic tunnel:New choice for portal vein thrombosis during liver transplantation
作者机构：Department of Liver Surgery and Organ Transplantation CenterThe Third People’s Hospital of ShenzhenThe Second Affiliated Hospital of Southern University of Science and TechnologyNational Clinical Research Center for Infectious DiseaseShenzhen 518000Guangdong ProvinceChina
出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)
年 卷 期：2022年第14卷第10期
页 面：1131-1140页
核心收录：
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
基 金：the Third People’s Hospital of Shenzhen Scientific Research Project,No.G2021008 and No.G2022008 Shenzhen Key Medical Discipline Construction Fund,No.SZXK079 Shenzhen Science and Technology Research and Development Fund,No.JCYJ20190809165813331 and No.JCYJ20210324131809027
主 题：Liver transplantation Portal vein thrombosis Portal vein reconstruction Retropancreatic tunnel Computer tomography angiography Three-dimensional visualization
摘 要：BACKGROUND Thrombectomy and anatomical anastomosis(TAA)has long been considered the optimal approach to portal vein thrombosis(PVT)in liver transplantation(LT).However,TAA and the current approach for non-physiological portal reconstructions are associated with a higher rate of complications and mortality in some *** To describe a new choice for reconstructing the portal vein through a posterior pancreatic tunnel(RPVPPT)to address cases of unresectable *** Between August 2019 and August 2021,245 adult LTs were ***-five(18.4%)patients were confirmed to have PVT before surgery,among which seven underwent PV reconstruction via the RPVPPT *** retrospectively analyzed the surgical procedure and postoperative complications of these seven recipients that underwent PV reconstruction due to *** During the procedure,PVT was found in all the seven cases with significant adhesion to the vascular wall and could not be *** portal vein proximal to the superior mesenteric vein was damaged in one case when attempting thrombolectomy,resulting in massive *** was successfully performed in all patients with a mean duration of 585 min(range 491-756 min)and mean intraoperative blood loss of 800 mL(range 500-3000 mL).Postoperative complications consisted of chylous leakage(n=3),insufficient portal venous flow to the graft(n=1),intra-abdominal hemorrhage(n=1),pulmonary infection(n=1),and perioperative death(n=1).The remaining six patients survived at 12-17 mo *** The RPVPPT technique might be a safe and effective surgical procedure during LT for complex ***,follow-up studies with large samples are still warranted due to the relatively small number of cases.
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