肝移植术后胆管狭窄的内镜治疗

Endoscopic management of bile duct stricture after liver transplantation

目的探讨内镜下胆道塑料双支架治疗肝移植术后胆管狭窄的应用价值。方法回顾性分析2005年1月～2006年12月20例肝移植胆管狭窄经内镜胆道双支架治疗的临床资料。结果全组20例均成功放置胆道塑料双支架。15例治疗有效;1例拔管后3月部分胆管再狭窄,再次内镜下置入胆道双支架;4例合并肝内胆管狭窄疗效不明显,长期置管。术后高淀粉酶血症2例,胆管炎3例,经保守治疗治愈。结论内镜下胆道塑料双支架治疗肝移植术后胆管吻合口狭窄是安全有效的治疗方法。

Objective To explore the value of double plastic biliary stents treatment of bile duct stricture after liver transplantation via endoscopy. Methods Clinical records of 20 cases of bile duct stricture after liver transplantation treated by double plastic biliary stents from January. 2005 to December 2006 were respectively reviewed. Results Twenty patients were received double plastic biliary stents treatment through endoscopy successfully. Treatment of 15 cases were effective, but 4 cases with intrahepatic bile duct stricture were not effective. One patient suffered restenosis in 3 months after removed stents, and was replaced 2 biliary stents by endoscopy again. Hyperamylasemia occurred in 2 cases after endoscopic treatment, and acute cholangitis occurred in 3 cases. The patients were cured by conservative treatment. Conclusion Double plastic biliary stents treatment through endoscopy is an effective and safe therapeutic approach for anastomosis stricture after liver transplantation.