生体肝移植術後腸閉塞に対して腹腔鏡下癒着剥離術を施行した2例

抄録

Few descriiptions of the treatment of postoperative bowel obstruction after living-donor liver transplantation (LDLT) have been published. We report on two patients who suffered postoperative bowel obstruction after LDLT and underwent laparoscopic adhesiolysis.

[Case 1] A man in his seventies who had underwent LDLT (right lobe graft) for liver cirrhosis with hepatocellular carcinoma. Seven years later, he was admitted to the hospital with abdominal pain and fever, and received the diagnosis of bowel obstruction with afferent loop syndrome. Laparoscopy revealed encapsulating bowel adhesion, and laparoscopic adhesiolysis was performed.

[Case 2] A female in her teens who had underwent LDLT (lateral segment graft) for congenital biliary atresia. Fourteen years later, she was admitted to the hospital with abdominal pain and vomiting, and received the diagnosis of bowel obstruction. Because the laparoscopy revealed internal herniation of the jejunum by a string-like adhesion, she underwent adhesiolysis. Postoperative courses were uneventful in both patients. The laparoscopic approach was safely performed for small bowel obstruction after living donor liver transplantation.