liver tranplanstation

Title of Operation:

Liver transplantation with caval preservation.

Indications for Surgery:

福建省立医院基本外科黄东航

Mr. *** *** is a very pleasant gentleman with hepatitis C, cirrhosis, severe encephalopathy, and severe accumulation with abdominal ascites. This has been essentially a life-threatening condition.  He has for the most part had a lowish MELD.  He recently up MELD"ed and was able to be allocated a high-quality donor organ.

Preoperative Diagnosis:

Hepatitis C.

End-stage liver disease.

Postoperative Diagnosis:

Hepatitis C.

End-stage liver disease.

Anesthesia:

Specimen (Bacteriological, Pathological or other):

Prosthetic Device/Implant:

Surgeons Narrative:

After consenting him and his family, we moved onto the operating room, he underwent general anesthesia.  He was prepped and draped in standard sterile fashion.  After that took place, we entered with a generous chevron incision.  There was copious ascites probably 6 liters when we entered the abdomen.  There was no previous adhesion or surgery.  We quickly placed a retractor, mobilized the left lobe, mobilized the right lobe.  He had extrahepatic veins, which were easy to see.  We dissected the porta, dividing his hepatic artery.  His portal vein and his common bile duct, these were all of normal caliber.  We mobilized the caudate off the vena cava and divided the left middle hepatic veins and the right as well.  At this point in time, the liver was removed from the field.  The graft was brought to the field. We over stapled each end of the vena cava.
We made a longitudinal cavotomy.  We placed a side-biting long type clamp on the recipient vena cava, performed a cavocavostomy with a running 3-0 Prolene, performed a portal vein anastomosis with a running 6-0 Prolene. Reperfusion was fairly unremarkable.  There was a brief period of hypotension.  We then sewed the arterial anastomosis with an interrupted 6-0 Maxon and lastly we removed the bile duct and sew the bile duct, duct-to-duct with an interrupted 5-0 Maxon.  We placed 3 standard drains and 1 additional drain to relieve abdominal ascites accumulation and we closed in layers.  The patient was taken to the SICU in stable condition.

CLINICAL STAGE OF TUMOR:

CC List:

Referring Physician CC List:

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