Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
World J Gastroenterol. 2012 Dec 21;18(47):7122-6. doi: 10.3748/wjg.v18.i47.7122.
Hemobilia is a rare biliary complication of liver transplantation. The predominant cause of hemobilia is iatrogenic, and it is often associated with traumatic operations, such as percutaneous liver intervention, endoscopic retrograde cholangiopancreatography, cholecystectomy, biliary tract surgery, and liver transplantation. Percutaneous transhepatic cholangiography and liver biopsy are two major causes of hemobilia in liver transplant recipients. Hemobilia may also be caused by coagulation defects. It can form intracholedochal hematomas, causing obstructive jaundice. Herein we describe a patient with an intracholedochal hematoma resulting in significant obstructive jaundice after liver transplantation for fulminant hepatic failure. Previous studies have shown that percutaneous transhepatic manipulation is a major cause of hemobilia after liver transplantation, but in our case, percutaneous transhepatic intervention was used to relieve the biliary obstruction and dissolve the biliary clot, with a good outcome.
肝出血是肝移植后一种罕见的胆道并发症。肝出血的主要原因是医源性的,常与经皮肝脏介入、内镜逆行胰胆管造影、胆囊切除术、胆道手术和肝移植等创伤性操作有关。经皮经肝胆管造影和肝活检是肝移植受者肝出血的两个主要原因。肝出血也可能由凝血缺陷引起。它可形成胆总管内血肿,导致阻塞性黄疸。本文描述了 1 例肝移植术后因暴发性肝衰竭导致胆总管内血肿并引起显著阻塞性黄疸的患者。既往研究表明,经皮经肝操作是肝移植后肝出血的主要原因,但在我们的病例中,经皮经肝介入用于解除胆道梗阻和溶解胆道血栓,取得了良好的效果。