肝移植术后胆泥形成9例报告

To discuss causes of biliary sludge formation after liver transplantation

[目的]探讨肝移植术后胆泥形成的原因。[方法]对9例肝移植术后发生胆泥的临床资料进行回顾性分析。[结果]9例发生胆泥的时间为1.5-11个月,平均（4.8±2.69）个月,供肝热缺血时间为3-8 min,平均（4.5±1.36）min,冷缺血时间为5-16 h,平均（9.5±4.3）h;胆道冲洗时间在热缺血后8-12 min,平均（9.5±1.21）min;开放血流后0.5-4 min,平均（1.6±1.04）min供肝胆总管有胆汁排出。3例术后1个月内出现急性排斥反应。[结论]肝移植术后发生胆泥有多种原因,其中主要是缺血/再灌注损伤、肝动脉供血不足、胆道冲洗不充分及急性排斥反应等。

[ Objective] To discuss the causes of biliary sludge formation after liver transplantation. [ Methods] The clinical data of 9 cases of biliary sludge complication after liver transplantation was analyzed retrospectively. [ Results ] Among these patients,the biliare sludge formation occurred between 1.5 and 11 mouths （4.8 ±2.69） months with the mean warm and cold ischemic time being from 3 to 8 minutes （4.5 ± 1.36） minutes and from 5 to 16 hours （9.5 ±4.3） hours respectively. Biliary tract was washed between 8 and 12 minutes （9.5 ± 1.21 ） minutes after the warm ischemic. There was bile effusing from the bile duct of donor liver between 0.5 and 4 minutes （ 1.6 ± 1.04） minutes after liver blood circulation opening. Three cases occurred acute cellular rejection within 1 month about pest - operation. [ Conclusion] There are a lot of causes about biliary sludge formation after liver transplantation, including ischemia reperfusion injury, insufficient blood supply to the bile duct, insufficient bile duct irrigation and acute rejection and so on.