A Comparison of Open Surgery and Endovascular Intervention for Hepatic Artery Complications After Pediatric Liver Transplantation

被引:15
作者
Wakiya, T. [1 ,2 ]
Sanada, Y. [1 ]
Mizuta, K. [1 ]
Urahashi, T. [1 ]
Ihara, Y. [1 ]
Yamada, N. [1 ]
Okada, N. [1 ]
Egami, S. [1 ]
Nakata, M. [3 ]
Hakamada, K. [2 ]
Yasuda, Y. [4 ]
机构
[1] Jichi Med Univ, Dept Transplant Surg, Shimotsuke, Tochigi 3290498, Japan
[2] Hirosaki Univ, Sch Med, Dept Surg, Hirosaki, Aomori 036, Japan
[3] Jichi Med Univ, Dept Radiol, Shimotsuke, Tochigi 3290498, Japan
[4] Jichi Med Univ, Dept Surg, Shimotsuke, Tochigi 3290498, Japan
关键词
PROTOCOL DOPPLER ULTRASONOGRAPHY; URGENT REVASCULARIZATION; THROMBOSIS; RECONSTRUCTION; MANAGEMENT; STENOSIS; IMPACT;
D O I
10.1016/j.transproceed.2012.08.012
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
There are currently 2 major therapeutic options for the treatment of hepatic artery complications: endovascular intervention and open surgery. We herein report a retrospective analysis of 14 pediatric patients with hepatic artery complications after pediatric living donor liver transplantation (LDLT) at our institution. We divided them into an open surgery group and an endovascular intervention group based on their primary treatment, and compared the results and outcomes. We then evaluated which procedure is more effective and less invasive. In the open surgery group, recurrent stenosis or spasm of the hepatic artery occurred in 3 of the 8 patients (37.5%). In the endovascular intervention group, 5 of the 6 patients were technically successfully treated by only endovascular treatment. Of the 5 successfully treated patients, 3 developed recurrent stenosis (60%). There were significant differences in the mean length of the operation for the first treatment of hepatic artery complications (open surgery, 428 minutes vs endovascular intervention, 160 minutes; P = .01) and in the mean value of the posttreatment aspartate aminotransferase (AST)/alanine aminotransferase (ALT) (open surgery > endovascular intervention; P = .04/.05). Although endovascular intervention needs to be examined in further studies to reduce the rate of relapse, it is a less invasive method for the patient and graft than open surgery.
引用
收藏
页码:323 / 329
页数:7
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