【摘要】 目的探讨肝门部胆管癌是否为肝移植的适应证。方法为２例肝门部胆管癌的患者施行了同种原位肝移植术。供肝切取采用腹腔器官联合快速切取法，灌洗液及保存液为ＵＷ液。无肝期采用ＢｉｏＭｅｄｉｃｕｓ转流泵行体外静脉转流。术后免疫抑制治疗，例１采用环孢素Ａ、泼尼松和硫唑嘌呤三联用药，例２采用霉酚酸酯代替硫唑嘌呤。结果移植后肝功能恢复正常，黄疸减退，但例１术后４天因血液浓缩而出现脑栓塞，肺内感染，术后１２天死于多器官功能衰竭；例２移植后４周顺利出院，但５个月后死于肿瘤复发。结论肝门部胆管癌ＢｉｓｍｕｔｈⅣ型仍不失为肝移植的适应证，但术前判定是否有微转移灶及术前、术中与术后有效的辅助治疗、防止肿瘤复发等是需要解决的重要课题更多还原

【Abstract】 Objective To investigate whether or not that klatskin tumor is adapt to liver transplantation. Methods In April 1995 and Nov. 1997, orthotopic liver transplantation was successfully performed on 2 cases of klatskin tumor. The liver graft was harvested by combined rapid multiple organ harvesting technique, flushed and preserved with UW solution. Venovenous bypass was processed with BioMedicus pump in anhepatic phase. Immunosuppressive protocol was cyclosporin A, prednisone and azathioprine, while azathioprine was replaced by cellcept in case 2. Results Liver function recovered rapidly with an obvious regression of jaundice. Hemoconcentration occurred in case one on the 4th postoperative day, followed by cerebral thrombosis and lung infection, and died of multiple system organ failure on the 12th postoperative day. Another one was discharged 4 weeks postoperation, but died of tumor recurrence after 5 months. Conclusion The Bismuth hilar bile duct cancer is adapt to liver transplantation. But how to assess whether or not there are micrometastases before operation and effectively control tumor recurrence postoperation are important projections needed to resolve.更多还原