Liu Yong-feng, Li Gui-chen, Wu Gang, Zhang Jia-lin, Liu Shu-rong, Meng Yi-man, Cheng Ying, Yang Lei, Sun Ming-jun, Zhang Xi-tong
Department of General Surgery, First Hospital of China Medical University, Shenyang 110001, China.
Zhonghua Wai Ke Za Zhi. 2008 Jun 15;46(12):911-3.
To study the prevention and treatment of biliary complications after orthotopic liver transplantation.
Clinical data of 183 recipients who had received liver transplantation between May 1995 and December 2006 were retrospectively analyzed.
Biliary complications occurred in 15 patients (15/183, 8.2%). The incidence for short-term and long-term complication were 6.0% (11/183) and 2.2% (4/183) respectively. No biliary complications was due to hepatic artery thrombosis(HAT). Four cases who received PTC(percutaneous transhepatic cholangiography) with stent insertion,8 cases who received ERCP( endoscopic retrograde cholangiopancreatography) with stent insertion and 1 who received Roux-en-Y choledochojejunostomy for anastomotic stricture were successfully cured. Two cases required relaparotomy died for fungus infection eventually. The mortality due to biliary complications was 1.1%.
The rapid combined abdominal organ harvesting technique could shorten the ischemia time and ameliorate the injury due to vascular and bile duct variances, which could reduce the incidence of biliary complication. PTC and (or) ERCP combined with stent insertion were main procedure for biliary complications not related to HAT after liver transplantation.
研究原位肝移植术后胆道并发症的防治。
回顾性分析1995年5月至2006年12月期间183例接受肝移植受者的临床资料。
15例患者发生胆道并发症（15/183，8.2%）。短期和长期并发症的发生率分别为6.0%（11/183）和2.2%（4/183）。无胆道并发症是由肝动脉血栓形成（HAT）所致。4例行经皮经肝胆管造影（PTC）并置入支架，8例行内镜逆行胰胆管造影（ERCP）并置入支架，1例行Roux-en-Y胆总管空肠吻合术治疗吻合口狭窄，均成功治愈。2例需再次剖腹手术的患者最终因真菌感染死亡。胆道并发症导致的死亡率为1.1%。
快速联合腹部器官获取技术可缩短缺血时间，改善因血管和胆管变异所致的损伤，从而降低胆道并发症的发生率。PTC和（或）ERCP联合置入支架是肝移植术后非HAT相关胆道并发症的主要治疗方法。
