Kasahara M, Sakamoto S, Fukuda A, Shigeta T, Tanaka H, Mastuno N, Hashimoto M, Kondo Y, Nosaka S, Nakazawa A
Department of Transplant Surgery, National Center for Child Health and Development, Tokyo, Japan.
Transplant Proc. 2010 Nov;42(9):3862-4. doi: 10.1016/j.transproceed.2010.08.054.
An 8-year-old female patient, known to have post-Kasai biliary atresia with mild intrapulmonary shunting, underwent living donor liver transplantation because of recurrent cholangitis. After the treatment of postoperative biliary stricture with percutaneous transhepatic biliary drainage, the patient subsequently developed hematochezia with portal vein thrombosis. The intraoperative findings showed portal vein thrombosis with a bilioportal fistula. We performed closure of the bilioportal fistula and reconstruction of the portal vein with a native internal jugular vein interposition graft. A bilioportal fistula due to percutaneous hepatobiliary procedures is a reportedly a rare complication following liver transplantation. The patient is currently doing well after a successful surgical intervention.
一名8岁女性患者，已知患有Kasai术后胆道闭锁并伴有轻度肺内分流，因复发性胆管炎接受了活体供肝移植。在经皮经肝胆道引流治疗术后胆道狭窄后，患者随后出现便血并伴有门静脉血栓形成。术中发现门静脉血栓形成并伴有胆门瘘。我们进行了胆门瘘闭合术，并使用自体颈内静脉间置移植进行门静脉重建。据报道，经皮肝胆道操作导致的胆门瘘是肝移植后一种罕见的并发症。经过成功的手术干预，患者目前情况良好。
