肝移植胆道重建的手术技巧

The operative skills of the biliary reconstruction in 132 cases undergoing liver transplantation

目的探讨原位肝移植手术中胆道重建的手术技巧。方法回顾性分析132例原位肝移植患者的临床资料,总结胆道重建的手术技巧。结果132例患者的手术成功率为93.94%,术后出现胆道并发症者12例(9.85%),其中胆管狭窄6例,胆泥淤积或结石3例,肝断面胆漏者2例(劈离式肝移植患者),T管拔除后胆瘘1例。除1例胆道狭窄者行再次肝移植,因发生严重感染导致肝功能衰竭死亡外,其余患者获得满意的效果。结论胆道并发症是肝移植术后的常见并发症,而良好的胆道重建技术是预防肝移植术后胆道并发症的重要保证。

Objective To investigate the operative skills of the biliary reconstruction in ortho- topic liver transplantation. Methods A retrospective analysis was used to study 132 cases subject to orthotopic liver transplantation consecutively performed in our transplantation center from Jun. 2002 to Apr. 2005. Results The successful rate was 93.94 % , and the biliary complication was identified in 12 of 132 cases who underwent biliary reconstruction with an incidence of 9. 85 %. One patient developed bile leakage after T tube removed, 2 patients developed bile leakage above the hepatic section, 6 patients bile duet strictures and 3 patients biliary calculi. Besides one patient was died after retransplantation because of infection, and all others were successfully cured. Conclusion Biliary complications are common after liver transplantation. The prefect operative skills of the biliary recons truction are the key to avoid biliary complication.