Roos Floris J M, Poley Jan-Werner, Polak Wojciech G, Metselaar Herold J
Best Pract Res Clin Gastroenterol. 2017 Apr;31(2):227-235. doi: 10.1016/j.bpg.2017.04.002. Epub 2017 Apr 12.
Biliary complications are considered to be the Achilles' heel of liver transplantation. The most common complications are leaks and bile duct strictures. Strictures can arise at the level of the anastomosis (anastomotic strictures; AS) or at other locations in the biliary tree (non-anastomotic strictures; NAS). Endoscopic treatment via endoscopic retrograde cholangiopancreatography (ERCP) is considered to be the preferred therapy for these complications. This review will focus on the diagnostic modalities, new insights in etiology of biliary complications and outcomes after different endoscopic therapies, in both deceased donor transplantation and living-donor liver transplantations. Advances in recent therapies, such as the use of self-expendable metal stents (SEMS) and endoscopic therapy for patients with a bilio-digestive anastomosis will be discussed.
胆道并发症被认为是肝移植的致命弱点。最常见的并发症是渗漏和胆管狭窄。狭窄可发生在吻合口水平（吻合口狭窄；AS）或胆管树的其他部位（非吻合口狭窄；NAS）。通过内镜逆行胰胆管造影术（ERCP）进行内镜治疗被认为是这些并发症的首选治疗方法。本综述将聚焦于诊断方式、胆道并发症病因的新见解以及在尸体供肝移植和活体供肝移植中不同内镜治疗后的结果。还将讨论近期治疗的进展，如使用可自膨胀金属支架（SEMS）以及对胆肠吻合患者的内镜治疗。
