The prophylaxes and treatment of postoperative complications in orthotopic liver transplantation / 临床外科杂志

ABSTRACT

Objective To investigate the common reasons,prophylaxes and treatment of postoperative complications in orthotopic liver transplantation (OLT).Method Seventy two patients who underwent OLT during recent three years were collected and analyzed retrospectively.Results OLT was performed on 50 cases with benign diseases including terminal liver cirrhosis 34;and 22 cases with and malignant diseases including hepato cellular carcinoma 19 cases.Fifty four complications were occurred postoperatively,including secondary abdominal cavity bleeding (4 cases ),severe infection of ascites (2 cases),stress gastric ulcer with bleeding and perforation (1 cases),biliary leak (6 cases),pulmonary infection (21 cases),and enteric fungal infection (5 cases).There were no primary dysfunction of liver and vascular complications.Follow up 2-41 months, without biliary complications and chronic liver dysfunction occurred 6 cases death postoperative,6 cases death on follow-up period.Total surrival rate is 83.33%, 32 cases alive more than 1 year,the longest surrival cases is 41 months postoperative.Conclusions It is suggested that the cases with cirrhosis are main indication for liver transplantation.The patients with liver cirrhosis always combinated of liverdisfunction,coagulopaphy,malnutrition and poor immune functions and we should pay attention to replace that of coagulation factors,antibiotics using and nutrition support perioperatively.Good surgical technique is the key point for preventing vascular complications.