Hiatt J R, Quinones-Baldrich W J, Ramming K P, Brems J, Busuttil R W
Surg Gynecol Obstet. 1987 Jul;165(1):89-93.
Operation upon the biliary tract is a discipline within transplantation of the liver. There exists a background of basic science information concerning anatomy and physiology, an historical evolution of surgical techniques, a divergence of contemporary opinion regarding preferred approaches and a body of well described complications. The complication rate, once more than one-half with substantial contribution to mortality rates, now ranges from approximately 15 to 25 per cent. Current practice in most institutions is to use choledochocholedochostomy with T-tube stent when a recipient duct is present and Roux-en-Y choledochojejunostomy with internal stent when a suitable recipient duct is absent. Hepatic arterial thrombosis is an important cause of complications of the biliary tract. The overlap of symptoms and signs of rejection with those of biliary sepsis and other complications of the biliary tract underscores the need for algorithmic use of diagnostic modalities in the post-transplant period.
胆道手术是肝脏移植领域的一个分支。它有关于解剖学和生理学的基础科学信息背景、手术技术的历史演变、当代关于首选手术方法的不同观点以及大量详细描述的并发症。并发症发生率曾超过一半且对死亡率有很大影响，现在约为15%至25%。大多数机构目前的做法是，当有受体胆管时采用带T管支架的胆总管对端吻合术，当没有合适的受体胆管时采用带内支架的Roux-en-Y胆总管空肠吻合术。肝动脉血栓形成是胆道并发症的一个重要原因。排斥反应的症状和体征与胆系感染及其他胆道并发症的症状和体征相互重叠，这突出表明在移植后阶段需要按算法使用诊断方法。
