Operation timing and methods of separation surgery for joined liver of conjoined twins: a report of three Cases / 中华肝胆外科杂志

ABSTRACT

Objective To approach the surgical timing for the conjoined twins, location of the separation line for the joined liver, and the separation method.Methods The common bile ducts of the conjoined twins were considered as two vertical lines, and a vertical line running parallel to the two lines was set as the separation line for the joined liver.Local blood flow blocking method was then used to separate the joined liver.Results Among all the three cases of the conjoined twins, one case was with sternoxiphopagus and the other two with thoracoabdominalpagus.All the three cases of con-joined twins shared the common livers, but each case had respectively separated gallbladders and bile ducts.They underwent the surgical separation at the age of 28 d and 96 d and 89 d successfully.Their liver sections bled rarely by blocking the local blood flow.The liver function recovered successfully af-ter the operation.All the 6 sick children recovered and were discharged from our hospital.Conclusion Porvided the conjoined twins shared the joined liver with respectively separated common bile ducts, in most cases, the injuries of the important liver vascular as well as bile ducts could be avoided when the separation line for the joined liver was selected with the common bile ducts of the conjoined twins as the longitudinal coordinate.The local blood flow blocking method only blocked the local blood flow, in-terfering to the liver blood flow in the non-operating areas rarely, which was instrumental in the recovery of the liver function and increase of the survival rate of the conjoined twins after the operation.