肝移植术后胆道并发症的介入治疗

The roles of interventional radiology procedure in the management of biliary complication after liver transplantation

目的探讨原位肝移植术后胆道并发症的介入治疗疗效。方法回顾性分析我院2002年6月至2005年9月诊治的173例原位肝移植患者的临床资料。结果术后出现胆道并发症14例(8.1%),其中胆管狭窄6例,胆管狭窄合并胆漏1例,胆泥淤积或结石3例,肝断面胆漏2例(劈离式肝移植患者),T管拔除后胆漏1例,Oddi括约肌功能失常1例。除1例胆道狭窄再次行肝移植,因发生严重感染导致肝功能衰竭死亡外,其余患者经介入治疗均获得满意的效果。结论介入治疗是诊断和治疗肝移植术后胆道并发症的首选方法。

Objective To investigate the roles of interventional radiology procedure in the management of biliary complication after liver transplantation. Methods The clinical data of 173 patients who underwent orthotopic liver transplantation were analyzed retrospectively. Results 14 out of 173 patients developed postoperative biliary complications and the incidence rate was 8. 1%. The corn plications induced biliary stricture in 6 cases, biliary stricture and biliary leakage in 1, malfunction of Oddi＇s sphincter in 1, biliary calculi in 3, biliary leakage of the cut surface of the graft in 2 with split liver transplantation, biliary leakage following T tube removal in 1. Except that one patient with biliary stricture died of liver failure due to serious infection after retransplantation, all others were cured. Conclusions Interventional treatment is an effective and safe measure in the diagnosis and treatment of the biliary tract complications after orthotopic liver transplantation.