肝移植术后胆道并发症的内镜治疗
Endoscopic management of post-liver transplant biliary complications.
作者信息
Girotra Mohit, Soota Kaartik, Klair Jagpal S, Dang Shyam M, Aduli Farshad
机构信息
Mohit Girotra, Kaartik Soota, Jagpal S Klair, Shyam M Dang, Farshad Aduli, Division of Gastroenterology and Hepatology, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.
出版信息
World J Gastrointest Endosc. 2015 May 16;7(5):446-59. doi: 10.4253/wjge.v7.i5.446.
Abstract
Biliary complications are being increasingly encountered in post liver transplant patients because of increased volume of transplants and longer survival of these recipients. Overall management of these complications may be challenging, but with advances in endoscopic techniques, majority of such patients are being dealt with by endoscopists rather than the surgeons. Our review article discusses the recent advances in endoscopic tools and techniques that have proved endoscopic retrograde cholangiography with various interventions, like sphincterotomy, bile duct dilatation, and stent placement, to be the mainstay for management of most of these complications. We also discuss the management dilemmas in patients with surgically altered anatomy, where accessing the bile duct is challenging, and the recent strides towards making this prospect a reality.
摘要
由于肝移植数量的增加以及受者生存期的延长，肝移植术后患者出现胆道并发症的情况越来越多。这些并发症的整体管理可能具有挑战性，但随着内镜技术的进步，大多数此类患者由内镜医师而非外科医生进行处理。我们的综述文章讨论了内镜工具和技术的最新进展，这些进展已证明经内镜逆行胰胆管造影术及各种干预措施，如括约肌切开术、胆管扩张术和支架置入术，是处理大多数此类并发症的主要手段。我们还讨论了解剖结构经手术改变、胆管进入困难患者的管理难题，以及在使这一前景成为现实方面取得的最新进展。
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