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胆管直径对肝移植术后胆道并发症的影响

Influence of Bile Duct Diameter on Biliary Complications After Liver Transplantation.

作者信息

Reyes María Pérez, Fernández Aguilar Jose Luis, de Cabo Sara Nicolás, León Díaz Francisco Javier, Rodríguez Marta Pérez, Pérez Belinda Sánchez, Pérez Daga Jose Antonio, Santoyo Julio Santoyo

机构信息

Liver Transplant Unit, Department of Surgery, Regional University Hospital, Malaga, Spain.

Liver Transplant Unit, Department of Surgery, Regional University Hospital, Malaga, Spain.

出版信息

Transplant Proc. 2020 Mar;52(2):569-571. doi: 10.1016/j.transproceed.2019.12.031. Epub 2020 Feb 6.

Abstract

Biliary complications after liver transplantation have a high incidence of and a significant impact on morbidity and mortality. The primary aim of this study was to assess the influence of bile duct diameter on biliary complications and to determine whether a critical diameter for such complications could be determined. The secondary aim was to identify additional factors associated with biliary complications. Two hundred and seventy-three recipients of liver transplantation with biliary anastomosis without a T-tube were analyzed from December 2013 to December 2018. Patients with a follow-up of less than 6 months were excluded, except for those with biliary complications (including death). Intraoperative measurements of bile duct diameter and other variables potentially related to complications were recorded prospectively, and their association with biliary complications was analyzed. Our results show that neither donor nor recipient bile duct diameters were risk factors for the development of biliary complications. However, bile duct size mismatch between recipient and donor was found to be a risk factor. Additional associated risk factors were arterial ischemia time, arterial complications, bench arterial reconstruction, and intraoperative blood transfusion.

摘要

肝移植术后胆道并发症的发生率很高,对发病率和死亡率有重大影响。本研究的主要目的是评估胆管直径对胆道并发症的影响,并确定是否可以确定此类并发症的临界直径。次要目的是确定与胆道并发症相关的其他因素。对2013年12月至2018年12月期间273例行肝移植且未放置T管进行胆管吻合的受者进行了分析。随访时间少于6个月的患者被排除,但有胆道并发症(包括死亡)的患者除外。前瞻性记录术中胆管直径测量值及其他可能与并发症相关的变量,并分析它们与胆道并发症的关联。我们的结果表明,供体和受体的胆管直径均不是发生胆道并发症的危险因素。然而,发现受体与供体之间的胆管大小不匹配是一个危险因素。其他相关危险因素包括动脉缺血时间、动脉并发症、体外动脉重建和术中输血。

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