Soubrane O
Clinique Chirurgicale Hôpital Cochin, Paris.
Ann Radiol (Paris). 1994;37(5):368-71.
Reconstruction of the biliary tree is the last step of a liver transplant procedure. The two techniques currently used are anastomosis of the common bile ducts with or without a Kehr drain and anastomosis to a Roux-en-Y jejunal limb. The latter procedure is usually done when the former is not feasible (missing or abnormal bile duct in the recipient). Biliary complications still occur in 5% to 25% of liver transplant recipients. The most common are fistulas and, above all, stenosis of the anastomosis. Treatment usually requires a surgical procedure to repair the anastomosis, drain a fistula, or perform a Roux-en-Y jejunal anastomosis. However, some complications are amenable to endoscopic or percutaneous treatment.
胆管重建是肝移植手术的最后一步。目前使用的两种技术是胆总管吻合术（有无克赫尔引流管）以及与空肠袢的Roux-en-Y吻合术。当前者不可行（受者胆管缺失或异常）时，通常采用后者。肝移植受者中仍有5%至25%会发生胆道并发症。最常见的是瘘管，尤其是吻合口狭窄。治疗通常需要进行手术修复吻合口、引流瘘管或进行Roux-en-Y空肠吻合术。然而，一些并发症适合内镜或经皮治疗。
