中国活体肝移植供者微创手术技术指南(2024年版)

doi:10.3877/cma.j.issn.1674-3903.2024.02.002

微创外科学在现代医学中扮演着至关重要的角色，微创手术因它兼具创伤小、操作精细、出血量少、术后恢复快等优势近年来在肝移植领域被逐渐应用广泛，包括上腹部正中小切口活体供肝切取、腹腔镜辅助活体供肝切取、全腹腔镜活体供肝切取、机器人活体供肝切取。自2002年法国Cherqui教授首次报道全腹腔镜活体左外叶供肝切除术以来，微创技术在活体肝移植领域的应用开始日渐广泛。为了指导我国微创肝移植供肝切除术更规范、安全、有效地开展，于2023年8月中华医学会器官移植学分会及中国医师协会器官移植医师分会组织全国肝移植专家共同制订《中国活体肝移植供者微创手术技术指南(2024年版)》，以为我国开展活体肝移植供者微创手术的外科医生提供科学的指导和参考。

关键词: 活体肝移植, 供者, 微创手术, 指南

Minimally invasive surgery played a crucial role in modern medicine. With advantages such as less trauma, precise operation, minimal bleeding, and rapid postoperative recovery, minimally invasive procedures had been increasingly applied in the field of liver transplantation in recent years. This included techniques such as small incision living donor hepatectomy through an upper abdominal midline incision, laparoscopic-assisted living donor hepatectomy, pure laparoscopic living donor hepatectomy, and robotic living donor hepatectomy. Since professor Cherqui from France firstly reported the total laparoscopic left lateral sectionectomy in living donors in 2002, the application of minimally invasive technology in living donor liver transplantation had become increasingly widespread. Based on this, so as to guide the more standardized, effective, and safe implementation of minimally invasive liver donor hepatectomy across the country, in August 2023, the Branch of Organ Transplant of Chinese Medical Association and the Branch of Organ Transplant Physicians of Chinese Medical Doctor Association organized national liver transplantation experts to jointly formulate the "Chinese guidelines for minimally invasive surgical techniques in living donor liver transplantation (2024 edition)". This is to provide scientific guidance and reference for surgeons performing minimally invasive surgery on living liver donors in China.

Key words: Living donor liver transplantation, Donor, Minimally invasive surgery, Guideline

表1 循证医学证据分级

证据级别	定义
Ⅰ级	同质随机对照试验的系统评价
	单项随机对照试验(可信区间窄)
	全或无病案系列研究
Ⅱ级	同质队列研究的系统评价
	单项队列研究(包括低质量随机对照试验，如随访率<80%)
	结果研究，生态学研究
Ⅲ级	同质病例对照研究的系统评价
	单项病例对照研究
Ⅳ级	病例系列研究(包括低质量队列及病例对照研究)
Ⅴ级	基于经验未严格论证的专家意见

表1 循证医学证据分级

证据级别	定义
Ⅰ级	同质随机对照试验的系统评价
	单项随机对照试验(可信区间窄)
	全或无病案系列研究
Ⅱ级	同质队列研究的系统评价
	单项队列研究(包括低质量随机对照试验，如随访率<80%)
	结果研究，生态学研究
Ⅲ级	同质病例对照研究的系统评价
	单项病例对照研究
Ⅳ级	病例系列研究(包括低质量队列及病例对照研究)
Ⅴ级	基于经验未严格论证的专家意见

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Chinese guidelines for minimally invasive surgical techniques in living donor liver transplantation (2024 edition)

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Chinese guidelines for minimally invasive surgical techniques in living donor liver transplantation (2024 edition)