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日本自1989年首次为胆道闭锁(CBA)行肝移植成功后,开辟了肝移植治疗 CBA 的新时代。本文总结了1990年至今京都大学移植免疫中心对157例CBA 行肝移植的经验。本组均为 Kasai 肝门部肝肠吻合术后的病例,其中作2次以上 Kasai 手术者占16.5%,由于手术次数多,移植手术时出血量较多,手术时间长,术后感染等并发症亦较多。一次 Kasai 手术后行肝移植的生存率为91.8%,二次 Kasai 手术后行肝移植的生存率为73.1%。故近年来第1次 Kasai 手术失败再次Kasai 手术的病例日益减少。
After the success of Japan’s first transplant of the biliary atresia (CBA) in 1989, it opened up a new era of CBA for liver transplantation. This article summarizes the experience of 157 CBA patients with liver transplantation from 1990 to now at the Transplantation Immunization Center, Kyoto University. This group are Kasai hepatic portal anastomosis cases, of which more than 2 times Kasai surgery accounted for 16.5%, due to the number of operations, more bleeding during transplant surgery, a long period of surgery, postoperative complications such as infection Also more. Survival of a liver transplant was 91.8% after a Kasai operation, and 73.1% after a second Kasai operation. Therefore, the first Kasai surgery in recent years failed to reduce the number of Kasai surgery.