Impact of New Portal Reconstruction Strategy on Portal Vein Growth and Outcomes in Living-Donor Liver Transplantation for Small Children With Biliary Atresia.

IF 2.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Hikaru Aoki, Eri Ogawa, Takashi Ito, Elena Yukie Uebayashi, Shinya Okumura, Yuki Masano, Tatsuya Okamoto, Hironori Haga, Hideaki Okajima, Etsuro Hatano
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引用次数: 0

Abstract

Background/purpose: We evaluated the outcomes of a new reconstruction method that we adopted in 2017 for small children with biliary atresia, involving aggressive resection of the sclerotic portal vein (PV), larger anastomotic orifice, and proactive vein graft interposition.

Methods: Data from 85 patients with biliary atresia (excluding one) aged < 3 years who underwent living-donor liver transplantation from January 2011 to December 2022 were retrospectively reviewed. Patients were categorized into former ("before 2017") and latter ("after 2017") groups, comprising 47 and 38 patients, respectively, according to their surgery time.

Results: The percentage of trunk reconstruction cases decreased from 51% to 26%, whereas that of vein graft interposition cases increased from 38% to 68% (p = 0.021). PV complication rates improved significantly from 19% to 3% (p = 0.035). Over 6 months postoperatively, the PV diameter was < 6 mm in 44% of cases in the former group but improved to 0% in the latter group (p < 0.01). Platelet counts at 1 year postoperatively were significantly higher in the latter group.

Conclusions: In living-donor liver transplantation for small children with biliary atresia, aggressive resection of the sclerotic PV, large anastomotic orifice, and proactive vein graft interposition may reduce PV complications and provide appropriate portal dilation for body growth.

新的门静脉重建策略对胆道闭锁儿童活体肝移植门静脉生长和预后的影响。
背景/目的:我们评估了我们在2017年采用的一种新的胆道闭锁儿童重建方法的结果,包括积极切除硬化门静脉(PV)、扩大吻合口和主动静脉移植物介入。方法:85例老年胆道闭锁患者(不含1例)的资料。结果:胆道重建术的比例从51%下降到26%,静脉移植的比例从38%上升到68% (p = 0.021)。PV并发症发生率由19%显著改善至3% (p = 0.035)。结论:在胆道闭锁儿童活体肝移植中,积极切除硬化PV,扩大吻合口,主动静脉移植物介入可减少PV并发症,为机体生长提供适当的门静脉扩张。
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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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