HEPATECTOMY METHOD FOR ORTHOTOPIC LIVER TRANSPLANTATION

摘要

FIELD: medicine.;SUBSTANCE: invention relates to surgery and may be useful for hepatectomy in orthotopic liver transplantation. Cross circular ligament of the liver before the visualization of the hepatic veins. Cross the left triangular ligament and ligaments of the small epiploon from the hepatic-duodenum ligament to the diaphragm. They produce a dissection of the hepatoduodenal ligament. In the left lower corner of the wound, the common hepatic artery (OPA) is determined, from which its branch, the gastroduodenal artery (GDA), departs. Cross and bandage the right gastric artery. With the help of dissection, the OPA is isolated, bypassing the bleeding lymph node that covers this artery, and displacing it to the head of the pancreas, OPA is isolated to the mouth of the GDA and its own hepatic artery, which is isolated for 1–1.5 cm, then it is ligated and crossed. Preserve the bile duct. Common hepatic duct is cut off. Between OPA and the common bile duct, the portal vein is visualized, which, with the help of coagulation and the intersection of its individual branches, is isolated to the site of its formation from the splenic and superior mesenteric veins. Stitched the subhepatic section of the inferior vena cava with a ligature, pulling to the right and up together with the left lobe of the liver, while crossing from 1 to 4 veins going into the inferior vena cava (NPV) from the first segment of the liver. Completely free the left side of the NPV. Mobilize the right lobe of the liver, pulling it up and to the left, dissecting the right triangular ligament. Allocate the right side of the retro-neural section of the NPV from the liver parenchyma, while retaining the upper wall of the NPV. Perform ligation and intersection of the portal vein. Clamp the NPV with Satinsky's clamp, keeping the blood flow through the NPV. Continue the separation of the liver, ligating and cutting off the left, middle, right hepatic veins and branches between them, bending the liver with the edges up.;EFFECT: method increases the viability of the transplanted liver.;1 cl, 1 ex