Caval reconstruction techniques in orthotopic liver transplantation

• 作者: Bryan A Whitson Eliza W Beal Elmahdi A Elkhammas Mitchell L Henry Shaylyn C Bennett Sylvester M Black
• 来源期刊: 世界外科手术杂志
• 学科: 医学
• 关键词: Caval replacement PIGGYBACK technique Conventional LIVER TRANSPLANT Standard LIVER TRANSPLANT VENOVENOUS BYPASS Portocaval SHUNT
• 年，卷（期）: 2015,（1）
• 页码范围: 41-57
• 页数: 17页
• 分类号: R

摘要

There are several caval reconstruction techniques currently in use for orthotopic liver transplantation.These include caval replacement or the conventional technique,performed with or without venovenous bypass,piggyback technique with anastomosis with two or three hepatic veins with or without cavotomy and modifications of the piggyback technique including end-to-side and side-to-side cavocaval anastomosis.There are few randomized controlled trials comparing the use of these techniques and our knowledge of their comparability is based on a few multi-and many single-center retrospective and prospective reviews.Although there are advantages and disadvantages for each technique,it is advisable that the surgeon perform the technique with which they have the most the experience and at which they are the most skilled as excellent outcomes can be obtained with any of the caval reconstruction options discussed.