肝移植术后门静脉系统并发症的血管内介入治疗

Percutaneous intravascular interventional treatment of portal venous complications after liver transplantation

目的:探讨介入治疗肝移植术后门静脉系统并发症的价值。方法:回顾性分析2012年1月至2019年5月期间6例肝移植术后门静脉系统并发症的介入治疗及其疗效。结果:门静脉主干闭塞3例,均成功开通门静脉;门静脉吻合部狭窄3例,狭窄程度均大于 75%,2例合并狭窄近肝段门静脉瘤。6例均成功置入门静脉支架,共放置支架7枚。所有患者术后均未发生门静脉治疗相关的并发症。4例有临床症状的患者介入术后症状消失,肝功能异常者逐渐恢复正常。术后分别随访10、34、61、68、71及80个月,6例患者门静脉血流通畅,支架无狭窄,无血栓形成。结论:经皮经肝血管内介入治疗是肝移植术后门静脉系统并发症的一种安全、有效的治疗方法。

Objective To evaluate the value of percutaneous interventional therapy for complications of portal vein system after liver transplantation.Methods Using retrospective analysis in 6 patients with portal vein complications after liver transplantation under interventional treatment between January 2012 and May 2019.Results Portal vein occlusion was successful in all 3 cases.Portal vein anastomosis stenosis was greater than 75%in 3 cases,and stenosis was associated with portal vein tumor near hepatic segment in 2 cases.Portal vein stents were successfully implanted in all 6 patients,and a total of 7 stents were placed.No postoperative complications related to portal vein therapy occurred in all patients.The 4 patients with clinical symptoms disappeared after interventional surgery,and the patients with abnormal liver function gradually returned to normal.The patients were followed up for 10,34,61,68,71 and 80 months after the operation.6 patients had unobstructed portal vein blood flow,no stent stenosis and no thrombosis.Conclusion Percutaneous intravascular intervention is a safe and effective method for the treatment of portal venous complications after liver transplantation.