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Reconstructing the portal vein through a posterior pancreatic tunnel:New choice for portal vein thrombosis during liver transplantation

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World Journal of Gastrointestinal Surgery 2022年第10期14卷 1131-1140页

作者： Dong Zhao Yi-Ming Huang Zi-Ming Liang Kang-Jun Zhang Tai-Shi Fang Xu Yan Xin Jin Yi Zhang Jian-Xin Tang Lin-Jie Xie Xin-Chen Zeng Department of Liver Surgery and Organ Transplantation Center The Third People’s Hospital of ShenzhenThe Second Affiliated Hospital of Southern University of Science and TechnologyNational Clinical Research Center for Infectious DiseaseShenzhen 518000Guangdong ProvinceChina

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.

关键词： Liver transplantation Portal vein thrombosis Portal vein reconstruction Retropancreatic tunnel computer tomography angiography Three-dimensional visualization

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Initial study of 3D Perfused blood volume imaging by 64-detector CT in anterior circulation hyperacute cerebral infarction in 3 hours

Initial study of 3D Perfused blood volume imaging by 64-dete...

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全国第十三次中西医结合影像学术研讨会全国中西医结合影像学研究进展学习班福建省第八次中西医结合影像学术研讨会

作者： Hai-Yun Zhu Dao-Ying Geng 解放军第八五医院放射科

Purpose:To evaluate the value of 3D CT whole brain perfused volume(3D PBV)based on CT angiography(CTA)row data in hyperacute cerebral ***:35 patients with stroke in 3 hours performed no enhancement CT(NECT)and CTA scan.3D software Neuro PBV was utilizes to process the CTA row data and PBV of brain was *** examination was performed in 6 hours after CT *** ischemic lesion volume and quantity on 3D PBV and NECT were compared with ***:In 35 patients,the number of infarct lesion detected by MRI,PBV,NECT was 40,38,16 *** results of Kappa analysis between NECT and PBV with MR were-0.0128,*** result of Paired t-test for measurement of volume between PBV and MRI was t=7.249,P>*** lesions’which did not been detected by PBV volume were less than 4.5cm3Conclusion:3D PBV has the potential to assess the full extent of an ischemic stroke at an early stage,whereas PBV is limited to a relatively small ***3D PBV technique requires no additional x-ray exposure and contrast medium injection,and can be performed in a short period of time.

关键词： Stroke computer tomography angiography Magnetic resonance imaging

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