Surgery, Division of Multiorgan Transplantation, Stanford University Medical Center, Stanford Surgery, UCSF, Stanford, CA, USA.
Clin Transplant. 2010 Nov-Dec;24(6):E230-5. doi: 10.1111/j.1399-0012.2010.01289.x.
We sought to determine factors that predict the successful surgical repair of biliary complications after adult living donor liver transplantation (ALDLT).
Records of 82 consecutive ALDLT right lobe recipients were reviewed. Operations were performed on 19 recipients for biliary complications. Post-operative biliary complications were analyzed. Fisher's exact test was used to identify variables that correlated with successful surgical repair.
A total of 29 recipients had biliary complications, of which 19 had a surgical repair. The five recipients, operated on for a stricture without history of leaks, did not develop further complications. However, nine of 14 with a history of a leak developed further complications after surgical repair (p-value = 0.044). All five who presented with a biliary complication more than 100 d after transplant had successful surgical repair; however, nine out of 13 who presented within 57 d had additional complications after repair.
Operations for strictures after ALDLT are more successful than operations for leaks. Recipients with isolated biliary strictures after ALDLT can be managed surgically; however, recipients with history of a leak often require additional interventions after surgical repair.
我们旨在确定预测成人活体肝移植（ALDLT）后胆道并发症成功手术修复的因素。
回顾了 82 例连续的 ALDLT 右叶受者的记录。19 例因胆道并发症而行手术。分析术后胆道并发症。采用 Fisher 确切检验确定与成功手术修复相关的变量。
共有 29 例受者发生胆道并发症，其中 19 例行手术修复。5 例因狭窄而无漏病史的受者未发生进一步并发症。然而，14 例有漏病史的受者中有 9 例在手术修复后出现进一步并发症（p 值=0.044）。所有在移植后 100 d 以上出现胆道并发症的 5 例受者均成功接受手术修复；然而，在修复后出现额外并发症的 13 例受者中，有 9 例在 57 d 内出现。
ALDLT 后狭窄的手术治疗比漏的手术治疗更成功。ALDLT 后孤立性胆道狭窄的受者可通过手术治疗；然而，有漏病史的受者往往需要在手术修复后进行额外的干预。
