Ebook Ultrasound-Guided liver surgery (edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Ultrasound-Guided liver surgery (edition): Part 2
Ebook Ultrasound-Guided liver surgery (edition): Part 2
Part IVLiver TransplantationLiver Transplantation from Deceased Donors10Matteo Cescon, Fabio Piscaglia, Alessandro Cucchetti, and Antonio Daniele Pinn Ebook Ultrasound-Guided liver surgery (edition): Part 2naDoppler ultrasonography (US) provides an accurate assessment of the hepatic vasculature in liver transplantation (LT). It can be performed pcri-opcratively or at the bedside. The evaluation of the hepatic vessels includes color and spectral Doppler analysis. ColorDoppler provides information regar Ebook Ultrasound-Guided liver surgery (edition): Part 2ding the presence and direction of flow, as well as the location of turbulent flow in a post-stenotic segment. Spectral analysis describes the directiEbook Ultrasound-Guided liver surgery (edition): Part 2
on, velocity, and phasicity of How.10.1Hepatic Artery ComplicationsThere are several possible sites of hepatic artery (H/X) anastomosis. In orthotopicPart IVLiver TransplantationLiver Transplantation from Deceased Donors10Matteo Cescon, Fabio Piscaglia, Alessandro Cucchetti, and Antonio Daniele Pinn Ebook Ultrasound-Guided liver surgery (edition): Part 2 ■A. D. PinnaGeneral Surgery and Transplantation Unit.Department of Medical and Surgical Sciences.University of Bologna.Via Massarcnli 9. 40138 Bologna. Italye-mail: matteo.cescon@unibo.itF. Piscagliae-mail: fabio.piscaglia@unibo.itA. Cucchettie-mail: aleqko@liber».itA. D. Pinnae-mail: antoniodaniel Ebook Ultrasound-Guided liver surgery (edition): Part 2e.pinna@aosp.bo.itcither the bifurcation into left and right hepatic arteries or the origin of the gastroduodenal artery. When the recipient HA cannotEbook Ultrasound-Guided liver surgery (edition): Part 2
be used, the anastomosis can be performed on the recipient aorta with a donor artery interposition graft, on the recipient splenic artery or on an acPart IVLiver TransplantationLiver Transplantation from Deceased Donors10Matteo Cescon, Fabio Piscaglia, Alessandro Cucchetti, and Antonio Daniele Pinn Ebook Ultrasound-Guided liver surgery (edition): Part 2or right, left, proper or common HA. and the recipient right, left, proper or common HA. with or without interposition vascular grafts. Knowledge of the type of anastomosis is important because stenosis frequently occurs at this site. I LX complications include thrombosis, stenosis, and pseudoaneury Ebook Ultrasound-Guided liver surgery (edition): Part 2sm. Biliary ischemia is often the consequence of HA thrombosis or stenosis [1.2], with development of non-anastomotic biliary strictures or leaks.On DEbook Ultrasound-Guided liver surgery (edition): Part 2
oppler U.S. the normal HA has a low-resistance waveform with continuous diastolic flow and a resistance index (Rl, defined as peak systolic velocity mPart IVLiver TransplantationLiver Transplantation from Deceased Donors10Matteo Cescon, Fabio Piscaglia, Alessandro Cucchetti, and Antonio Daniele Pinn Ebook Ultrasound-Guided liver surgery (edition): Part 2e, with an early peak and a highest peak (Fig. 10.1). For the measurement of systolic acceleration time, the early peak is to be used. For the measurement of Rl, the highest peak is to be used (Figs. 10.2 and 10.3). /Xn Rl lower than 0.50 in any hepatic arterial vessel indicates HA thrombosis or ste Ebook Ultrasound-Guided liver surgery (edition): Part 2nosis, with a sensitivity of 60 % and a specificity of 77 % 13, 4|. A prolonged systolic185G. Torzilli (ed.), Ultrasound-Guided Liver Surgery.DOI: 10.Ebook Ultrasound-Guided liver surgery (edition): Part 2
1007/978-88-470-5510-0_ 10. © Springer-Verlag Italia 2014186M. Cescon et al.Fig. 10.1 Arterial Doppler ultrasound waveform showing both early and highPart IVLiver TransplantationLiver Transplantation from Deceased Donors10Matteo Cescon, Fabio Piscaglia, Alessandro Cucchetti, and Antonio Daniele Pinn Ebook Ultrasound-Guided liver surgery (edition): Part 2is also predictive of stenosis, with a sensitivity/spccificity of 53 and 86 %, respectively (3,4J. A low Rl and/or a long acceleration determine the tardus parvus waveform (Figs. 10.4. 10.5. 10.6. 10.7. 10.8). At the site of stenosis, an increased peak systolic velocity (>200 cm/s) can be detected. Ebook Ultrasound-Guided liver surgery (edition): Part 2This is the most specific sign of hepatic arterial stenosis and. if present, is predictive in 96 % of the cases |3, 4|.Systolic acceleration timeFig.Ebook Ultrasound-Guided liver surgery (edition): Part 2
10.2 US arterial wave with representation of early and highest peaks. For the measurement of systolic acceleration time, the early peak is to be used.Part IVLiver TransplantationLiver Transplantation from Deceased Donors10Matteo Cescon, Fabio Piscaglia, Alessandro Cucchetti, and Antonio Daniele Pinn Ebook Ultrasound-Guided liver surgery (edition): Part 20.1.1ThrombosisAbsent arterial tlow in all arteries on a technically adequate Doppler imaging study is nearly always indicative of thrombosis. False positives may occur due to severe hepatic edema.Fig. 10.3 Normal Doppler US waveform of the right hepatic artery detected at its entrance into the righ Ebook Ultrasound-Guided liver surgery (edition): Part 2t liver lobe, alongside and anteriorly to the right portal branch. The systolic acceleration time is clearly normal (corresponding to a rapid rise ofEbook Ultrasound-Guided liver surgery (edition): Part 2
systolic velocity) and the RI is not decreased, namely the end diastolic velocity is relatively low with respect to peak velocity (numeric data not mePart IVLiver TransplantationLiver Transplantation from Deceased Donors10Matteo Cescon, Fabio Piscaglia, Alessandro Cucchetti, and Antonio Daniele PinnPart IVLiver TransplantationLiver Transplantation from Deceased Donors10Matteo Cescon, Fabio Piscaglia, Alessandro Cucchetti, and Antonio Daniele PinnGọi ngay
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