肝移植术后血管胆道并发症的介入治疗

Vascular and Biliary Complications after Liver Transplantation: Interventional Approaches

目的:评价介入治疗对肝移植后胆道、血管并发症的价值。材料和方法:18例肝移植患者接受了介入治疗。其中肝动脉狭窄8例,行肝动脉造影及溶栓治疗;下腔静脉及肝静脉狭窄2例,行内支架置入术;胆瘘及胆道狭窄8例,行PTCD治疗。结果:胆道并发症8例,PTCD治疗后症状消失;肝动脉狭窄8例,溶栓后肝动脉完全开放6例,1例血流部分开放,1例肝动脉血流未恢复再次肝移植治疗;下腔静脉及肝静脉狭窄2例内支架置入术后下腔静脉梗阻及肝肿大症状消失。结论:介入治疗是治疗肝移植后胆道血管并发症的有效方法。

To evaluate the value of interventional approaches on the vascular and biliary complications after liver transplantation. Materials and Methods： 18 patients after orthotopic liver transplantation received interventional approaches. Percutaneous transhepatic artery angiography and thrombolysis were performed in 7 cases, percutaneous transhepatic artery angiograph and percutaneous transluminal angioplasty（PTA） therapy in 1 patient, cholangiography in 8 cases, inferior vena cava angiography in 1 case, inferior vena cava and hepatic vein angiography in 1 case. Results： Eight cases with biUary complication performed PTCD; 8 patients performed hepatic artery angiography, among them, hepatic artery patency restored after transhepatic artery thrombolysis in 6 cases, restored partially in 1 patient, not restored in 1 case; 1 patient with IVC stenosis performed stent implantation; 1 patient with both IVC and hepatic vein stenosis performed IVC stent implantation and hepatic vein percutaneous tranluminal angioplasty （PTA） . Conclusion： Interventional approaches including PTCD, balloon angioplasty, stent placement, transartery thrombolysis are useful procedure for the treatment of the patient with vascular and biliary complications after liver transplantation.