tailieunhanh - Ebook Ultrasound-Guided liver surgery (edition): Part 2

(BQ) Part 2 book "Ultrasound-Guided liver surgery" presents the following contents: Liver transplantation (liver transplantation from deceased donor, liver transplantation from living donors), minimally invasive surgery and interventional procedures (liver transplantation from living donors, liver transplantation from living donors,.) | Part IV Liver Transplantation Liver Transplantation from Deceased Donors Matteo Cescon Fabio Piscaglia Alessandro Cucchetti and Antonio Daniele Pinna Doppler ultrasonography US provides an accurate assessment of the hepatic vasculature in liver transplantation LT . It can be performed peri-operatively or at the bedside. The evaluation of the hepatic vessels includes color and spectral Doppler analysis. ColorDoppler provides information regarding the presence and direction of flow as well as the location of turbulent flow in a post-stenotic segment. Spectral analysis describes the direction velocity and phasicity of flow. Hepatic Artery Complications There are several possible sites of hepatic artery HA anastomosis. In orthotopic whole LT the most frequent anastomosis is between the donor celiac or common HA and the recipient HA at M. Cescon F. Piscaglia A. Cucchetti A. D. Pinna General Surgery and Transplantation Unit Department of Medical and Surgical Sciences University of Bologna Via Massarenti 9 40138 Bologna Italy e-mail F. Piscaglia e-mail A. Cucchetti e-mail aleqko@ A. D. Pinna e-mail either the bifurcation into left and right hepatic arteries or the origin of the gastroduodenal artery. When the recipient HA cannot be used the anastomosis can be performed on the recipient aorta with a donor artery interposition graft on the recipient splenic artery or on an accessory HA. The presence of a donor accessory artery requires a second anastomosis. In split LT the anastomosis is variably performed between the donor right left proper or common HA and the recipient right left proper or common HA with or without interposition vascular grafts. Knowledge of the type of anastomosis is important because stenosis frequently occurs at this site. HA complications include thrombosis stenosis and pseudoaneurysm. Biliary ischemia is often the consequence of HA thrombosis or stenosis 1