肝移植术后胆道并发症病因及预防

INCIDENCE OF BILIARY COMPLICATIONS AFTER LIVER TRANSPLANTATION

目的分析原位肝移植术后胆1道并发症的病因。方法回顾性分析307例尸体供肝和40例活体供肝原位肝移植的临床资料,总结术后胆道并发症的病因。结果40例活体肝移植受体术后胆道并发症的发生率5.0%,307例尸体供肝肝移植受体术后胆道并发症的发生率为18.9%;肝内胆道狭窄和胆道铸型结石形成等严重胆道并发症在活体肝移植和放置“T”管的尸肝移植未发生。结论缺血时间尤其热缺血时间是导致严重胆道并发症的最主要的原因,放置“T”管引流能降低胆道并发症的发生率。

Objective To explore the etiology of biliary complications after orthotopic liver transplantation. Method 40 patients who underwent living donor liver transplantation were analyzed retrospectively. Results Biliary complications occurred in 2 recipients（5.0% ）among 40 patients who underwent LDLT, and 58 recipients （18.9%）among 307 patients who underwent cadaveric whole organ liver transplantation. There was no severe biliary complication including intrahepatic stricture, sludge and cast in recipients of LRLT and T tube drainage. Conclusions Warm isehemic time of grafts is the major reason which causes severe biliary complication,and T tube drainage can be used to decrease the incidence of bile duct complications.