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FI 2015

1,000
© Thomson Reuters, Journal Citation Reports, 2015

Indexada en:

SCIE/JCR, Index Medicus/Medline, IBECS, IME

Métricas

  • Factor de Impacto: 1,000(2015)
  • 5-años Factor de Impacto: 0,876
  • SCImago Journal Rank (SJR):0,243
  • Source Normalized Impact per Paper (SNIP):0,438

© Thomson Reuters, Journal Citation Reports, 2015

Cir Esp 1999;66:502
Obstrucción al drenaje de las venas suprahepáticas tras el trasplante hepático utilizando la técnica de preservación de vena cava: anastomosis suprahepática a 2 frente a 3 venas
OBSTRUCTION OF HEPATIC VEINS AFTER LIVER TRANSPLANTATION WITH VENA CAVA PRESERVATION: SUPRAHEPATIC ANASTOMOSIS INVOLVING TWO VEINS VERSUS THREE VEINS
R. Roblesa, P. Parrilla Pariciob, FS. Buenoa, P. Ramírezc, F. Acostad, J. Lópeze, JA. Lujánf, JM. Rodríguezf, Q. Hernándezg, JA. Fernándeze, F. Picóh
a Catedrático de Cirugía.
b Jefe de Departamento de Cirugía. Catedrático de Cirugía.
c Profesor titular de Cirugía.
d FEA de Anestesia. Profesor Asociado.
e MIR de Cirugía.
f FEA de Cirugía. Profesor Asociado.
g FEA de Cirugía.
h Jefe de Sección de Hemodinámica. Departamento de Cirugía. Unidad de Trasplante Hepático. Hospital Universitario Virgen de la Arrixaca. Murcia.
Resumen

Introduction. Vena cava preservation (VCP) has been associated with an increase in the incidence of hepatic vein obstruction (HVO), a complication that has been treated with different types of anastomosis. The objective of this study was to prospectively compare two techniques for anastomosis.

Patients and method. We studied 171 cases of liver transplantation involving VCP. In the first 87 procedures, suprahepatic anastomosis was performed with two hepatic veins (middle and left), while all three were employed in the remaining 84 cases. We compared the incidence and severity of intraoperative and postoperative HVO in the two groups.

Results. HVO was more significantly more frequent (p < 0.05) and severe when two veins were employed (n = 7, 8%) than when three were involved (n = 1, 1.2%). Five of the patients in whom two hepatic veins were used presented intraoperative venous stasis and two developed postoperative HVO (one with acute and the other with chronic Budd-Chiari syndrome). One of the patients in whom the three veins were employed presented intraoperative venous stasis. There were no problems with postoperative venous drainage.

Conclusion. VCP can be performed systematically using the three hepatic veins without venovenous bypass and with fewer complications related to HVO.

Palabras clave
Trasplante hepático, Síndrome de Budd-Chiari, Preservación de vena cava, Bypass venovenoso
Keywords
Liver transplantation, Budd-Chiari syndrome, Vena cava preservation, Venovenous bypass