Tang Fanfan, Song Jingtao, Cai Tanxing, Lei Zhao, Huang Feizhou, Hu Yina, Deng Gang
Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei 430015, China.
Department of Hepatobiliary Surgery, The Third Xiangya Hospital of Central South University, Institute of Hepatobiliary and Pancreatic Minimally Invasive Surgery, Central South University, Changsha, Hunan 410013, China.
Gastroenterol Res Pract. 2022 Aug 23;2022:4498443. doi: 10.1155/2022/4498443. eCollection 2022.
Liver transplantation (LT) is an effective treatment option for patients with end-stage liver disease; biliary complications are important cause of death in posttransplant patients. Endoscopic retrograde cholangiopancreatography (ERCP) has an irreplaceable role in the diagnosis and treatment of patients with biliary tract disease.
The clinical data of patients with biliary strictures (BS) after LT treated with ERCP admitted to the Third Xiangya Hospital of Central South University from September 2016 to October 2021 were reviewed; the changes in temperature, bilirubin, and albumin before and after treatment and postoperative complications were analyzed.
A total of 41 patients were included in the study, and biliary stents were successfully placed in 37 cases (90.2%), while 4 cases (9.8%) were unsuccessful due to complete BS. Patients with ERCP guided biliary stenting had a significant improvement in bilirubin index compared to the preoperative period ( < 0.05). 27 patients (73.0%) had complete relief of symptoms after 1 ERCP-guided treatment, and 10 patients (27.0%) developed BS again at different times after the first ERCP treatment, among which 8 patients developed BS again within 1 year after the first treatment and 2 patients developed BS again after 1 year after the first treatment. The incidence of endoscopy-related adverse events was 35.14%, with no serious adverse events.
ERCP-guided biliary stenting was an effective and safety treatment for BS after LT.
肝移植（LT）是终末期肝病患者的有效治疗选择；胆道并发症是移植后患者死亡的重要原因。内镜逆行胰胆管造影术（ERCP）在胆道疾病患者的诊断和治疗中具有不可替代的作用。
回顾性分析2016年9月至2021年10月在中南大学湘雅三医院接受ERCP治疗的LT术后胆道狭窄（BS）患者的临床资料；分析治疗前后体温、胆红素、白蛋白变化及术后并发症。
共纳入41例患者，37例（90.2%）成功置入胆道支架，4例（9.8%）因完全性BS置入失败。ERCP引导下胆道支架置入患者的胆红素指标较术前有显著改善（<0.05）。27例（73.0%）患者经1次ERCP引导治疗后症状完全缓解，10例（27.0%）患者在首次ERCP治疗后的不同时间再次发生BS，其中8例在首次治疗后1年内再次发生BS，2例在首次治疗后1年以上再次发生BS。内镜相关不良事件发生率为35.14%，无严重不良事件。
ERCP引导下胆道支架置入术是LT术后BS的一种有效且安全的治疗方法。
