超声诊治肝移植术后胆道并发症的体会

Ultrasonographic diagnosis and treatment of biliary complications after liver transplantation

目的总结超声在肝移植术后胆道并发症诊治中的应用价值。方法连续对40例肝移植术后患者移植肝及其胆道进行二维和彩色多普勒超声检查,并与手术、肝组织活检及其它影像学检查结果相对比。结果超声提示肝移植术后胆道并发症9例(22.5%),包括胆漏2例,胆道梗阻7例(胆管扩张6例,胆泥形成3例、胆石形成5例,胆道铸型形成1例。)。超声引导穿刺治疗胆漏2例。结论超声对肝移植术后胆道并发症的诊治具有重要的临床应用价值。

Objective To investigate the value of uhrasonography in the diagnosis and treatment of biliary complications after liver transplantation. Methods Uhrasonographyic examination was carried out in 40 patients undergone liver transplantation. The parenchyma and biliary tract of the transplanted liver were observed by B-mode ultrasonography and CDFI. The results of ultrasonography were compared with that of operation ,liver biopsy , biliary tract contrast examination through T tube, ERCP and PTC et al. Results 9 cases （22. 5% ）of biliary complications were diagnosed by uhrasonography. Ultrasonographic examinations detected biliary tract leaks in 2 cases ,obstructions of biliary tract in 7 eases（ dilatation of the biliary ducts in 6 cases , bile sludge formation in 3 cases , cholelithiasis in 5 cases and cast mould in 1 cases. ）. 2 cases of biliary leaks were drained under the guidance of ultrasonography. Conclusions Uhrasonography is of clinical value in the diagnosis and treatment of biliary complications after liver transplantation.