Vai trò của siêu âm trong đánh giá biến chứng sớm mạch máu mảnh ghép gan phải sau phẫu thuật ghép gan từ người hiến sống

Abstract

Objective: To evaluate early vascular complications in liver grafts following living-donor right liver transplantation during the patients' hospitalization using ultrasound. To determine the level of agreement between Doppler ultrasound and contrast-enhanced computed tomography in diagnosing these complications. Subject and method: 44 patients underwent living-donor right liver graft transplantation at 108 Central Military Hospital during 2024 and early 2025. Patients underwent daily ultrasound examinations for the first three days post-surgery in the Department of Surgical Intensive Care and Transplantation, on the 7^th, 14^th day and the time of suspected complication in the Department of Hepato-Pancreato-Biliary Surgery. The findings were compared with results from computed tomography scans on the 1^st day and 14^th day, and the time of suspected complication. Result: Regarding hepatic artery complications, 1 case (2.3%) of hepatic artery stenosis was detected via ultrasound, while 6 cases (13.6%) were identified using computed tomography (CT). No cases were detected via ultrasound, whereas CT identified 7 cases (15.9%) of portal vein stenosis. 1 patient with portal vein thrombosis was diagnosed using both ultrasound and CT. Ultrasound detected 1 patient (2.3%) with right hepatic vein stenosis, while CT detected 2 patients (4.6%). 1 patient with right hepatic vein thrombosis was observed on CT but not recorded via ultrasound. All patients with vascular complications post-transplantation in this study exhibited no clinical symptoms or laboratory abnormalities. Conclusion: Ultrasound plays a crucial role in the early diagnosis of vascular complications post-transplantation, aiding clinicians in determining appropriate management strategies. However, the concordance between ultrasound and computed tomography (CT) varies significantly in diagnosing different vascular complications.