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Etiology and management of intra-abdominal hemorrhage after orthotopic liver transplantation

2012-08-15 00:54:32MaYi
外科研究與新技術(shù) 2012年1期

/Ma Yi

(馬毅,Dept Transplant Surg,1st Affil Hosp,Sun Yat-sen Univ,Guangzhou 510080)…∥Chin JGen Surg.-2011,26(8).-625 ~628

ObjectiveTo explore the causes and management of intra-abdominal hemorrhage after orthotopic liver transplanktation(OLT).MethodsClinical data of 638 OLT patients were analyzed retrospectively from January 2004 to December 2008 in the First Affiliated Hospital of Sun Yat-sen University.The diagnosis and treatment of postoperative intra-abdominal hemorrhage after OLT were reviewed.ResultsAmong the 638 patients,53 suffered from posttransplant intra-abdominal hemorrhage,the morbidity was 8.3%(53/638).Thirty-one cases suffering from bleeding on raw surfaces or around the liver due to impairment of coagulation function were treated by non-surgery methods,22 cases who suffered from active postoperative intra-abdominal hemorrhage due to surgical factors underwent laparotomy and bleeding control operation after failure of anti-shock treatments such as hemostatic drugs,blood reperfusion.Among the 53 patients who suffered from intra-abdominal hemorrhage,12 patients died,and the main causes were serious infections and multiple organ dysfunction syndrome.The mortality associated with intraabdominal hemorrhage was 22.6%.ConclusionIntra-abdominal hemorrhage at different locations were found after OLT,and the fatal rate is quite high.Timely and appropriate treatments especially laparotomy may improve the prognosis of these patients.9 refs,1 tab

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