阿根廷 20 多年来使用肝移植治疗严重胆管损伤的经验：一项全国性调查结果。
Experience using liver transplantation for the treatment of severe bile duct injuries over 20 years in Argentina: results from a National Survey.
机构信息
General Surgery Service and Liver Transplant Unit, Hospital Italiano de Buenos Aires General Surgery and Liver Transplant Unit, Hospital Alemán de Buenos Aires, Buenos Aires, Argentina.
出版信息
HPB (Oxford). 2011 Aug;13(8):544-50. doi: 10.1111/j.1477-2574.2011.00322.x. Epub 2011 Jun 24.
BACKGROUND
Bile duct injury (BDI) is a severe complication that may arise during the surgical treatment of benign disease and a few patients will develop end-stage liver disease (ESLD) requiring a liver transplant (LT).
OBJECTIVE
Analyse the experience using LT as a definitive treatment of BDI in Argentina.
PATIENTS AND METHODS
A national survey regarding the experience of LT for BDI.
RESULTS
Sixteen out 18 centres reported a total of 19 patients. The percentage of LT for BDI from the total number of LT per period was: 1990-94 = 3.1%, 1995-99 = 1.6%, 2000-04 = 0.7% and 2005-09 = 0.2% (P < 0.001). The mean age was 45.7 ± 10.3 years (range 26-62) and 10 patients were female. The BDI occurred during cholecystectomy in 16 and 7 had vascular injuries. One patient presented with acute liver failure and the others with chronic ESLD. The median time between BDI and LT was 71 months (range 0.2-157). The mean follow-up was 8.3 years (10 months to 16.4 years). Survival at 1, 3, 5 and 10 years was 73%, 68%, 68% and 45%, respectively.
CONCLUSIONS
The use of LT for the treatment of BDI declined over the review period. LT plays a role in selected cases in patients with acute liver failure and ESLD.
背景
胆管损伤（BDI）是一种严重的并发症，可能发生在良性疾病的手术治疗过程中，少数患者会发展为终末期肝病（ESLD），需要进行肝移植（LT）。
目的
分析阿根廷使用 LT 作为 BDI 确定性治疗的经验。
患者与方法
一项关于 LT 治疗 BDI 经验的全国性调查。
结果
18 个中心中的 16 个报告了总共 19 名患者。LT 治疗 BDI 的比例占同期 LT 总数的百分比为：1990-94 年=3.1%，1995-99 年=1.6%，2000-04 年=0.7%，2005-09 年=0.2%（P<0.001）。平均年龄为 45.7±10.3 岁（范围 26-62），10 名患者为女性。BDI 发生在胆囊切除术期间的 16 例中，7 例有血管损伤。1 例患者发生急性肝功能衰竭，其余患者发生慢性 ESLD。BDI 与 LT 之间的中位时间为 71 个月（范围 0.2-157）。平均随访时间为 8.3 年（10 个月至 16.4 年）。1、3、5 和 10 年的生存率分别为 73%、68%、68%和 45%。
结论
在审查期间，LT 治疗 BDI 的使用呈下降趋势。LT 在急性肝功能衰竭和 ESLD 患者的一些选定病例中发挥作用。
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