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[胆道疾病的肝移植]

[Liver transplantation for biliary tract disease].

作者信息

Sang Xin-Ting, Huang Jie-Fu

机构信息

Liver Surgery Center, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2005 Aug;27(4):423-6.

Abstract

Biliary tract diseases have always been one of the important indications for liver transplantation. These biliary tract diseases include congenital atresia of biliary duct, biliary diseases with tendency of malignant transformation, malignant biliary diseases, primary biliary cirrhosis, and secondary biliary cirrhosis. The right time to consider liver transplantation for the above biliary diseases includes situations when transplantation is the only approach to treat the disease, the only effective approach to treat the disease, or one of the effective approaches to treat the disease. Currently there is still no commonly accepted pre-operative evaluation standard for biliary disease-related liver transplantation. However, it is important to obey the following principles. First, the diagnosis should be confirmed; secondary, the necessity or urgency of the liver transplantation should be clarified; and third, the patient and his/her family should understand the whole procedure of transplantation the risk and advantage of the surgery, and the potential life-long intake of immunosuppressors. This article will briefly review all these relavant issues based on the authors' personal experience and clinical cases.

摘要

胆道疾病一直是肝移植的重要指征之一。这些胆道疾病包括先天性胆管闭锁、有恶变倾向的胆道疾病、恶性胆道疾病、原发性胆汁性肝硬化和继发性胆汁性肝硬化。对于上述胆道疾病,考虑进行肝移植的合适时机包括移植是治疗该疾病的唯一方法、唯一有效方法或有效方法之一的情况。目前,对于与胆道疾病相关的肝移植,仍没有普遍接受的术前评估标准。然而,遵循以下原则很重要。首先,诊断应明确;其次,应明确肝移植的必要性或紧迫性;第三,患者及其家属应了解移植的整个过程、手术的风险和益处以及潜在的终身免疫抑制剂服用情况。本文将根据作者的个人经验和临床病例简要回顾所有这些相关问题。

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