肝移植术后早期非肝动脉栓塞性胆道缺血性损伤并发症的预防

Preclusion of ischemic biliary duct injury complication without hepatic artery thrombo-embolism during the early stage after liver transplantation

目的:探讨肝移植术后早期非肝动脉栓塞性胆道缺血性损伤并发症的预防。方法:对60例同种原位背驮式肝移植病人术中、术后采用改善供肝血液循环的策略。结果:术后6个月内出现胆道并发症3例,发生率为5%(5/60),1例因拔T管时发生胆漏;1例经T管胆道造影导致胆道感染,胆泥形成;1例胆道吻合口渗漏。结论:肝移植术中、术后扩张血管、改善胆管微循环是预防术后早期非肝动脉栓塞性胆道缺血性损伤并发症的重要措施。

Objective To explore an effective strategy to prevent ischemic biliary duct injury mithout concomitant hepatic artery thrombo-embolism during the early stage after live transplantation. Methods A vasodilator regimen was used to improve the hepatic circulation of 60 patients undergoing piggyback orthotopic liver transplantation （POLT）. Results Biliary duct complications occurred in 3 cases, including biliary leakage following extraction of the T tube in 1 case, biliary infection and sludge formation after cholangiography via the T tube in 1 case, and mild biliary anastomosis leakage in 1 case. Conduslom Vasodilator administration to improve the hepatic microcirculation during and after liver transplantation is of utmost importance to reduce the risk of isehemie biliary duct injury without concomitant hepatic artery thrombosis formation.