Department of Radiology, Myongji Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
Department of Radiology, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea.
Cardiovasc Intervent Radiol. 2021 Aug;44(8):1266-1272. doi: 10.1007/s00270-021-02826-0. Epub 2021 Apr 22.
To investigate clinical outcomes and safety of extraluminal recanalization for duct-to-duct anastomotic obstruction after living donor liver transplantation (LDLT).
Extraluminal recanalization was performed as a salvage procedure after failure of intraluminal cannulation in eight patients who underwent percutaneous transhepatic treatment of duct-to-duct anastomotic obstruction 11.0 ± 5.27 months after LDLT between October 2012 and April 2019. Technical details, safety, and outcomes of extraluminal recanalization were investigated.
Total ten sessions of extraluminal recanalization were performed in the eight patients with the stiff backend of a 0.035 inch hydrophilic guide wire, 22-gauge Chiba needle, or Colapinto needle. Percutaneous common bile duct access was performed in three sessions to obtain a straight course for the puncture. There was one instance of subcapsular and intraparenchymal hematoma requiring placement of an additional drainage catheter and conservative treatment. During a follow-up period ranging from 18.4 to 100.7 months, the drainage catheter was removed in seven of the eight patients, including three patients who had recurrent stricture requiring repeat percutaneous treatment and one who underwent a routine change of an endoscopic retrograde biliary drainage catheter.
Extraluminal recanalization can be an effective and safe salvage procedure after failed intraluminal cannulation of duct-to-duct anastomotic obstruction in LDLT.
研究活体肝移植（LDLT）后胆肠吻合口吻合口外再通治疗胆管吻合口阻塞的临床效果和安全性。
2012 年 10 月至 2019 年 4 月，8 例 LDLT 术后 11.0±5.27 个月发生胆肠吻合口吻合口阻塞的患者，经皮经肝治疗失败后，采用经皮经肝治疗作为挽救性治疗。研究了经皮经肝治疗的技术细节、安全性和效果。
8 例患者共进行了 10 次经皮经肝治疗，使用了 0.035 英寸亲水导丝的硬后端、22 号 Chiba 针或 Colapinto 针。在 3 次经皮经肝治疗中，进行了经皮经肝治疗以获得穿刺的直线路径。有 1 例患者发生了包膜下和肝实质血肿，需要放置额外的引流导管和保守治疗。在 18.4 至 100.7 个月的随访期间，8 例患者中有 7 例拔除了引流导管，其中 3 例因再发狭窄需要再次经皮治疗，1 例因常规更换内镜逆行胰胆管引流导管而拔除。
经皮经肝治疗是 LDLT 后胆肠吻合口吻合口阻塞经皮经肝治疗失败的一种有效、安全的挽救性治疗方法。
