METHOD FOR RECONSTRUCTING VENOUS CIRCULATION IN A TRANSPLANT AT ORTHOTOPIC HEPATIC TRANSFER

摘要

FIELD: medicine, surgery.;SUBSTANCE: one should partially squeeze a recipient's inferior vena cava due to applying a clamp onto it longitudinally followed by venotomy of anterior wall. Before venotomy one should dissect semilunarly the posterior semicircumference of suprahepatic department of the transplant's inferior vena cava so that its perimeter after dissecting and the perimeter of venotomic foramen in the recipient's inferior vena cava should be equal. Then it is important to form cavacaval anastomosis by "end-to-side" type so that the angle between longitudinal axes of the recipient's and the transplant's inferior vena cava corresponds to 30-45°, moreover, the suture of anastomosis' posterior wall should be fulfilled according to "parachute" technique by keeping partial longitudinal squeezing of the recipient's inferior vena cava till finishing the formation of cavacaval anastomosis. Then one should apply a clamp onto suprahepatic department of transplant's inferior vena cava being beyond anastomosis area and remove a clamp from the recipient's inferior vena cava by reconstructing the circulation along it and controlling the success of cavacaval anastomosis. Then it is necessary to form porto-portal anastomosis and reconstruct venous circulation in the transplant. The innovation enables to provide the safety in reconstructing venous circulation at orthotopic hepatic transfer due to controlling the success of cavacaval anastomosis prior to hepatic perfusion.;EFFECT: higher efficiency.;3 dwg, 1 ex