Use Of The Ligamentum Teres Hepatis For Outflow Reconstruction During Ex Vivo Liver Resection And Autotransplantation In Patients With End-stage Hepatic Alveolar Echinococcosis

Objective: To compare and evaluate the clinical efficacy of using ligamentum teres hepatis and autologous vascular in autologous liver transplantation outflow reconstruction.Methods: From August 2010 to September 2022,our center performed ex vivo liver resection and autotransplantation to treat a total of 151 patients with end-stage hepatic alveolar echinococcosis.This study retrospectively analyzed the clinical data of 68 patients according to the inclusion and exclusion criteria.According to different operative methods,they are divided into two group,37 repair with ligamentum teres hepatis as the ligamentum teres hepatis group,31 repair with autogenous vessel as the autogenous vessel group.The preoperative,intraoperative,postoperative and follow-up data of the two groups were compared and analyzed.The difference was statistically significant when P<0.05.Results: In this study,the operation were completed in all 68 cases,and no intraoperative death was found.During the follow-up period,the overall complication rate(59.46%)in the ligamentum teres hepatis group is significantly lower than that in the autologous vascular group with(87.09%),the differences is significant(P<0.05).There are no significant differences in postoperative liver vascular flow rate and reconstructive vascular complications between the two groups(P>0.05).The remnant liver volume,ratio of the remnant liver volume to the standard liver volume,operation time,and blood loss are all have no significant differences between the two groups(P>0.05).Conclusion: The ligamentum teres hepatis could be used as a safe and effective vascular replacement graft in ex vivo liver resection and autotransplantation;with the advantages of convenient,less traumatic,and less operation time,which has promising clinical application prospects.