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[儿童肝移植中的胆道并发症]

[Biliary complications in hepatic transplantation in children].

作者信息

Lloret J, Martínez Ibáñez V, Ezzedine M, Asensio M, Boix-Ochoa J

机构信息

Hospital Infantil Vall d'Hebrón, Barcelona.

出版信息

Cir Pediatr. 1993 Apr;6(2):63-5.

PMID:8357724
Abstract

Biliary reconstruction continuous to be a source of severe complications in paediatric liver transplantation (PLT). Five (7%) biliary complications in 70 PLT in patients aged from 8 months to 13 years with a body weight of 4-37 Kg. were studied. End-to-end common duct anastomosis (group I) with Kehr drainage was performed in 18 cases. End-to-side common duct jejunostomy (group II) was performed in the remaining 52 cases. In this group, two patients were found to have stenosis and biliary stones or sludge respectively and one obstruction with sludge without evident stenosis. All cases required surgery and there was no mortality. Transparietohepatic cholangiography has provided early diagnosis of these complications and has proved to be a reliable method of choice. The use of inert biological material in Kher tubes and steroids slow down the organization of a fistulous tract, thereby causing the complications which arose in group I.

摘要

胆道重建仍然是小儿肝移植(PLT)中严重并发症的一个来源。对70例年龄在8个月至13岁、体重4 - 37千克的PLT患者中的5例(7%)胆道并发症进行了研究。18例患者行端对端胆总管吻合术(I组)并置Kehr引流管。其余52例患者行胆总管空肠端侧吻合术(II组)。在该组中,分别有2例患者出现狭窄以及胆石或胆泥,1例出现梗阻伴胆泥但无明显狭窄。所有病例均需手术治疗,且无死亡病例。经皮肝穿刺胆管造影术已对这些并发症作出早期诊断,并且已被证明是一种可靠的选择方法。在Kehr管中使用惰性生物材料和类固醇会减缓瘘管的机化,从而导致I组出现并发症。

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