2009年12月
The New Method of Time-Lag Ligation for Portosystemic Shunt Using Coronary Artery Bypass Graft Occluder for Adult Living Donor Liver Transplantation
TRANSPLANTATION PROCEEDINGS
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- 巻
- 41
- 号
- 10
- 開始ページ
- 4259
- 終了ページ
- 4261
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1016/j.transproceed.2009.08.055
- 出版者・発行元
- ELSEVIER SCIENCE INC
We performed a living donor liver transplantation (LDLT) for a 57-year-old man who had end-stage liver failure with portal hypertension and an inferior mesenteric vein-left testicular vein (IMV-LTV) shunt. At operation, we did not clamp the shunt but encircled it with a coronary artery bypass graft (CABG) occluder (Sumitomo Bakelite K.K., Japan), which was passed outside the body through the abdominal wall to time-lag ligation (TLL). On postoperative day (POD) 5, we observed decreased portal flow. We performed TLL of the shunt using the CABG occluder without re-laparotomy. The portal flow increased, while the portal vein pressure increased slightly. In LDLT, portosystemic shunt has been reported to be a cause of portal thrombus formation or graft liver atrophy due to decreased PV flow in the mid postoperative period. However, perioperative ligation of a portosystemic shunt may prevent regeneration of the grafted liver because of excessive portal hypertension. Therefore the technique of time-lag ligation of a portosystemic shunt using a CABG occluder may be a minimally invasive, useful method to achieve physiological liver graft regeneration.
- リンク情報
- ID情報
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- DOI : 10.1016/j.transproceed.2009.08.055
- ISSN : 0041-1345
- Web of Science ID : WOS:000272968800046