肝移植术后血管胆道并发症的介入治疗

目的:评价介入治疗对肝移植后胆道、血管并发症的价值。材料和方法:18例肝移植患者接受了介入治疗。其中肝动脉狭窄8例,行肝动脉造影及溶栓治疗;下腔静脉及肝静脉狭窄2例,行内支架置入术;胆瘘及胆道狭窄8例,行PTCD治疗。结果:胆道并发症8例,PTCD治疗后症状消失;肝动脉狭窄8例,溶栓后肝动脉完全开放6例,1例血流部分开放,1例肝动脉血流未恢复再次肝移植治疗;下腔静脉及肝静脉狭窄2例内支架置入术后下腔静脉梗阻及肝肿大症状消失。结论:介入治疗是治疗肝移植后胆道血管并发症的有效方法。

Vascular and Biliary Complications after Liver Transplantation: Interventional Approaches

To evaluate the value of interventional approaches on the vascular and biliary complications after liver transplantation.Materials and Methods:18patients after orthotopic liver transplantation received interventional approaches.Percutaneous transhepatic artery angiography and thrombolysis were performed in7cases,percutaneous transhepatic artery angiograph and percutaneous transluminal angio-plasty(PTA)therapy in1patient,cholangiography in8cases,inferior vena cava angiography in1case,inferior vena cava and hepatic vein angiography in1case.Results:Eight cases with biliary complication performed PTCD;8patients performed hepatic artery angiography,among them,hepatic artery patency restored after transhepatic artery thrombolysis in6cases,restored partially in1patient,not restored in1case;1patient with IVC stenosis performed stent implantation;1patient with both IVC and hepatic vein stenosis performed IVC stent implantation and hepatic vein percutaneous tranluminal angioplasty(PTA).Conclusion:Interventional approaches including PTCD,balloon angioplasty,stent placement,transartery thrombolysis are useful procedure for the treatment of the patient with vascular and biliary complications after liver transplantation.