Ding Yi, Xing Yi-Xuan, Sun Nian-Zhe
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
Department of Pulmonary and Critical Care Medicine, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China.
World J Gastrointest Surg. 2025 Jul 27;17(7):108148. doi: 10.4240/wjgs.v17.i7.108148.
Bile leakage remains a formidable challenge in post-liver transplantation management, posing significant risks to patient outcomes and graft survival. This editorial provides a critical appraisal of the recent clinical study by Gu , which compared the efficacy of stent placement endoscopic nasobiliary drainage (ENBD) for treating post-transplant bile leaks. By retrospectively analyzing data from their institutional cohort of liver transplant recipients with bile leaks, the authors evaluated the therapeutic success rates and clinical outcomes between the stent and ENBD groups, with a focused discussion on the relative advantages of each approach. Gu demonstrated that both stent placement and ENBD were effective in managing post-transplant bile leaks, with comparable therapeutic outcomes. However, the study also recognized its limitations, such as the lack of an assessment of the impact of bile leak severity on outcome and the absence of long-term follow-up data. The editorial further highlights the pressing need for advancing research on long-term complications post-liver transplantation and underscores the pivotal role of clinical stratification and physician expertise in guiding therapeutic decisions. In summary, Gu 's study enhances our understanding of mitigating post-transplant complications like bile leaks and offers evidence-based insights to refine clinical protocols. This commentary aims to contextualize current research trends and future directions in the field, advocating for sustained innovation and evidence-driven practice.
胆漏仍然是肝移植术后管理中一项严峻的挑战，对患者预后和移植物存活构成重大风险。这篇社论对顾的近期临床研究进行了批判性评估，该研究比较了支架置入术与内镜鼻胆管引流术（ENBD）治疗移植后胆漏的疗效。通过回顾性分析其机构队列中肝移植受者胆漏的数据，作者评估了支架组和ENBD组的治疗成功率和临床结局，并重点讨论了每种方法的相对优势。顾证明支架置入术和ENBD在处理移植后胆漏方面均有效，治疗效果相当。然而，该研究也认识到其局限性，如缺乏对胆漏严重程度对结局影响的评估以及长期随访数据的缺失。这篇社论进一步强调了推进肝移植术后长期并发症研究的迫切需求，并强调了临床分层和医生专业知识在指导治疗决策中的关键作用。总之，顾的研究增进了我们对减轻移植后胆漏等并发症的理解，并提供了基于证据的见解以完善临床方案。这篇评论旨在将该领域当前的研究趋势和未来方向置于背景中，倡导持续创新和循证实践。
