Atwal Tegpal, Pastrana Mariel, Sandhu Bimaljit
Division of Gastroenterology, Hepatology and Nutrition, VCU Medical Center, Richmond, VA - 23298, USA.
J Clin Exp Hepatol. 2012 Mar;2(1):81-5. doi: 10.1016/S0973-6883(12)60085-1. Epub 2012 Apr 12.
Biliary tract complications remain a common source of morbidity and mortality in liver transplant (LT) recipients with an estimated incidence of 5-30% after orthotopic LT and a mortality rate of up to 10%. Biliary complications after LT may be related to various factors including hepatic artery thrombosis or stenosis, ischemia reperfusion injury, immunologic injury, infections, donor pool, and technical issues which include imperfect anastomosis and T-tube-related complications. Management of the detected biliary complications includes nonsurgical and surgical methods. A majority of these post transplant biliary complications can be treated with endoscopic retrograde cholangiography. If unsuccessful, a percutaneous intervention or surgery may be required. In this article, we review the incidence, clinical presentation, and management of the main types of biliary complications.
胆道并发症仍然是肝移植(LT)受者发病和死亡的常见原因,原位肝移植术后估计发生率为5%-30%,死亡率高达10%。肝移植术后的胆道并发症可能与多种因素有关,包括肝动脉血栓形成或狭窄、缺血再灌注损伤、免疫损伤、感染、供体库以及技术问题,其中技术问题包括吻合不完善和T管相关并发症。已检测到的胆道并发症的处理方法包括非手术和手术方法。这些移植后胆道并发症中的大多数可以通过内镜逆行胆管造影术进行治疗。如果不成功,则可能需要进行经皮介入或手术。在本文中,我们综述了主要类型胆道并发症的发生率、临床表现及处理方法。