■门静脉血栓形成是门静脉高压症患者终末期肝病的常见问题,而YerdelIV级血栓形成可能是肝移植的禁忌症。手术技术的进步表明了静脉移植如肾-门静脉吻合术的可行性。cavo-portalhemitransposition,但低移植门静脉血流灌注和局部门静脉高压是局限性。
■我们介绍了一种在肝移植患者中进行门静脉系统重建的新方法:一名28岁的男性被诊断为Budd-Chari综合征和门静脉高压并伴有IV级门静脉血栓。
■“拔出”技术用于血栓切除术,这可以帮助暴露肠系膜上静脉和门静脉分支,并减少与周围解剖结构的识别和分离相关的技术困难。收集足够的门静脉血液灌注,避免局部门静脉高压,通过双入路手术重建门静脉系统:肾-门静脉吻合术结合门静脉-门静脉吻合术。
■基于精确的术前评估,拔出技术和双入路手术的应用可能是一种有效的血栓切除术方法,尤其是在IV级门静脉血栓形成的情况下。
UNASSIGNED: Portal vein thrombosis is a common problem of end-stage liver disease in patients with portal hypertension and Yerdel grade IV thrombosis may be a contraindication for liver transplantation. Advances in surgical technique have indicated the feasibility of liver transplantation with PVT such as Reno-portal anastomosis, cavo-portal hemitransposition, but low graft portal blood perfusion and regional portal hypertension were the limitations.
UNASSIGNED: We introduce a new approach for portal system reconstruction in a patient underwent liver transplantation: A 28-year-old male was diagnosed with Budd-Chari syndrome and portal hypertension with grade IV portal vein thrombosis.
UNASSIGNED: The \"Pull-out\" technique was applicated for thrombectomy, which can aid in exposing the superior mesenteric vein and portal vein branches and reducing technical difficulties associated with the identification and dissociation of surrounding anatomical structures. To collect sufficient portal vein blood perfusion and avoid regional portal hypertension, the portal vein system was reconstructed through double-approach procedure: reno-portal anastomosis combined with portal-portal anastomosis.
UNASSIGNED: Based on a precision preoperative evaluation, application of the Pull-out technique and double-approach procedure may be an effective method of thrombectomy especially in cases of grade IV portal vein thrombosis.