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成人肝移植术后肠穿孔的治疗与结局:单中心经验

Treatment and outcome of intestinal perforation after liver transplant surgery in adults: a single-center experience.

作者信息

Lin Jianyu, Wang Jing, Yue Peng, Zhang Xingmao, Lang Ren, Wang Yuan, Cui Chen, He Qiang

机构信息

Integrated Department.

Patient Service Center, The Affiliated Hospital to Capital Medical University, Beijing Chaoyang Hospital.

出版信息

Ther Clin Risk Manag. 2017 May 31;13:675-678. doi: 10.2147/TCRM.S137161. eCollection 2017.

Abstract

OBJECTIVE

Intestinal perforation is a rare complication after liver transplantation. This study was designed to calculate the incidence and investigate the outcomes of intestinal perforation in adult liver transplant patients.

MATERIALS AND METHODS

The clinical records of liver transplant recipients between January 2014 and June 2016 were obtained. The incidence of intestinal perforation was calculated, and high risk factors were analyzed.

RESULTS

The mean operative time was 8.5 h (range: 6-11 h). The mean portal vein occlusion time was 66.5 min (range: 58-72 min), and the mean cold ischemia time was 7.9 h (range: 6.5-9.5 h). Four (2.7%) patients developed intestinal perforation from 9 to 14 days postliver transplant. All perforations were single and repaired by interrupted silk sutures. Two patients uneventfully recovered, but intestinal perforation recurred in two other patients. Simple repair was undertaken in one patient, and terminal ileum resection and ileostomy were performed in the other patient. There were no perioperative deaths.

CONCLUSION

The incidence of intestinal perforation after liver transplantation is low. Prompt diagnosis and treatment should be carried out to reduce comorbidities and mortality.

摘要

目的

肠穿孔是肝移植术后一种罕见的并发症。本研究旨在计算成年肝移植患者肠穿孔的发生率并调查其预后情况。

材料与方法

获取2014年1月至2016年6月期间肝移植受者的临床记录。计算肠穿孔的发生率,并分析高危因素。

结果

平均手术时间为8.5小时(范围:6 - 11小时)。平均门静脉阻断时间为66.5分钟(范围:58 - 72分钟),平均冷缺血时间为7.9小时(范围:6.5 - 9.5小时)。4例(2.7%)患者在肝移植术后9至14天发生肠穿孔。所有穿孔均为单发,采用间断丝线缝合修复。2例患者顺利康复,但另外2例患者肠穿孔复发。1例患者进行了单纯修复,另1例患者进行了末端回肠切除及回肠造口术。围手术期无死亡病例。

结论

肝移植术后肠穿孔的发生率较低。应进行及时诊断和治疗以降低合并症及死亡率。

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本文引用的文献

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Uncommon gastrointestinal complications after liver transplantation: radiologic findings and clinical features.
Acta Radiol. 2013 Feb 1;54(1):1-7. doi: 10.1258/ar.2012.120522. Epub 2012 Nov 2.
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