Yanaga K, Sugimachi K
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Surg Today. 1992;22(6):493-500. doi: 10.1007/BF00308892.
Biliary tract complications are often referred to as the "Achilles' heel" of liver transplantation and various techniques have been developed to overcome them. The two major methods of bile duct reconstruction currently in use consist of either (1) choledochocholedochostomy over a T-tube or, when duct-to-duct approximation is not feasible, choledochojejunostomy over an internal stent, or (2) interposition of the donor gallbladder as a conduit between the donor bile duct and either the recipient bile duct or a jejunal loop. Although these standardizations of biliary tract reconstruction have resulted in a reduction of biliary complications after liver transplantation, further advancement in the elucidation of ampullary obstruction and viability of the donor bile duct is needed.
胆道并发症常被称为肝移植的“阿喀琉斯之踵”，人们已开发出各种技术来克服这些并发症。目前使用的两种主要胆管重建方法包括：（1）经T管行胆总管对端吻合术，当胆管对端吻合不可行时，经内置支架行胆总管空肠吻合术；或（2）将供体胆囊作为供体胆管与受体胆管或空肠袢之间的管道进行置入。尽管这些胆道重建的标准化方法已使肝移植术后胆道并发症有所减少，但仍需要在阐明壶腹梗阻和供体胆管活力方面取得进一步进展。
