器官移植2025，Vol.16Issue(1)：67-73,7.DOI:10.12464/j.issn.1674-7445.2025023
腹腔镜联合上腹正中切口微创肝移植的概念、设计和临床应用
Concept,design and clinical application of minimally invasive liver transplantation through laparoscopic combined upper midline incision
摘要
Abstract
Objective To explore the technical process and clinical application of laparoscopic combined upper midline incision minimally invasive liver transplantation.Methods A retrospective analysis was conducted on 30 cases of laparoscopic combined upper midline incision minimally invasive liver transplantation.The cases were divided into cirrhosis group(15 cases)and liver failure group(15 cases)based on the primary disease.The surgical and postoperative conditions of the two groups were compared.Results All patients successfully underwent laparoscopic"clockwise"liver resection,with no cases of passive conversion to open surgery or intolerance to pneumoperitoneum.In 6 cases,the right lobe was relatively large,and the right hepatic ligaments could not be completely mobilized.One case required an additional reverse"L"incision during open surgery.All patients successfully completed the liver transplantation,with no major intraoperative bleeding,cardiovascular events,or other occurrences in the 30 patients.The model for end-stage liver disease(MELD)score in the cirrhosis group was lower than that in the liver failure group(P<0.001).There were no statistically significant differences between the two groups in terms of age,surgical time,blood loss,anhepatic phase,or cold ischemia time(all P>0.05).During the perioperative period,there was 1 case of hepatic artery embolism,1 case of portal vein anastomotic stenosis,no complications of hepatic vein and inferior vena cava,and 3 cases of biliary anastomotic stenosis,all of which occurred in the liver failure group.Conclusions In strictly selected cases,the minimally invasive liver transplantation technique combining laparoscopic hepatectomy with upper midline incision for graft implantation has the advantages of smaller incisions,less bleeding,relatively easier operation,and faster postoperative recovery,which is worthy of clinical promotion and application.关键词
肝移植/微创/腹腔镜/上腹正中切口/肝动脉栓塞/肝动脉血栓/吻合口狭窄/感染Key words
Liver transplantation/Minimally invasive/Laparoscopy/Upper midline incision/Hepatic artery embolization/Hepatic artery thrombosis/Anastomotic stricture/Infection分类
医药卫生引用本文复制引用
易述红,唐晖,曾凯宁,冯啸,傅斌生,杨卿,姚嘉,杨扬,陈规划..腹腔镜联合上腹正中切口微创肝移植的概念、设计和临床应用[J].器官移植,2025,16(1):67-73,7.基金项目
国家重点研发计划项目(2023YFC2505900) （2023YFC2505900）
广东省科技计划项目(20169013) （20169013）
广东地区临床高新、重大和特色技术项目(2023P-GX05) （2023P-GX05）
