目的

探讨肝移植术后并发症的再次手术治疗。

方法

对2002年6月至2007年3月肝移植病例中14例肝移植术后患者的17例次再次手术的临床资料进行回顾性分析。

结果

17次再次手术治疗手术成功率100%，1例因腹腔内出血于术后第10天死于肾功能衰竭并发ARDS，1例因胸穿后血胸于术后第20天死于严重的腹腔和肺部感染，1例因左肝内胆管结石伴胆道感染于术后第33天因多器官功能衰竭死亡，1例因肿瘤复发转移于再次术后25天死亡，其余10例成活至今且肝功能良好，生存率71.4%（10/14）。

结论

正确把握肝移植术后再次手术的适应证和手术时机，充分的手术前准备，术中精细操作，加强围手术期严密监测和正确处理是肝移植术后再次手术成功的关键。

Objective

To explore the clinical experience of treating the postoperative complications of orthotopic liver transplantation（OLT）by reoperation.

Methods

A retrospective analysis and review the clinical datum of over 200 OLT were performed in Fuzhou General Hospital from June 2002 to March 2007.14 of whom were underwent 17 reoperations totally.

Results

All of the 17 reoperations were performed successfully.The achievement rate is 100%.Four patients died at 10th，20th，33rd and 25th day respectively after reoperation.One died of renal failure combining with adult respiratory distress syndrome（ARDS）.One died of severe abdominal cavity and lung infection.One died of multiple organ failure（MOF）.One died of recurrence and metastasis of carcinoma.The other 10 patients were survived with good liver function，and the survival rate was 71.4%（10/14）.

Conclusion

Surgical procedure，indication，operative opportunity，perioperative monitoring and so on contribute to the increase of the achievement rate of reoperation after OLT.