逆行胰胆管造影在肝移植中的应用

目的探讨经内镜逆行胰胆管造影(ERCP)在诊断和治疗肝移植术后胆道并发症中的应用。方法对本院肝移植术后出现胆道并发症的16例患者进行ERCP检查,并根据情况分别行鼻胆管引流(ENBD)和/或内镜下乳头切开取石(EST)等治疗。结果ERCP确诊16例肝移植术后胆道并发症,发生率为9.47%,其中胆道结石6例,胆道狭窄3例,吻合口漏2例,胆道结石伴左肝管狭窄1例,吻合口胆漏伴胆道结石3例,1例示供受体胆管比例不一致,供体胆管相对狭窄,所有患者都得到有效治疗。结论内镜下ERCP是诊断和治疗肝移植术后胆道并发症的一种安全而有效的手段,可作为非手术治疗中的首选。

Application of endoscopic retrograde cholangiopancreatography in liver transplantation

Objective To investigate the application of endoscopic retrograde cholangiopancreatography(ERCP) in diagnosis and treatment of the biliary tract complications after orthotopic liver transplantation.WT5HZ]Methods ERCP was performed in 16 patients with biliary complications after liver transplantation who were respectively treated by endoscopic nasobiliary drainage(ENBD) and/or endoscopic sphincterotomy(EST).Results ERCP entirely confirmed the diagnosis of postoperative biliary complications including biliary stones(6),biliary stricture(2),anastomotic bile leak(2),biliary stones with left hepatic duct(1),anastomotic bile leak with biliary stones(3),and donor-recipient biliary uncompatibility(1) that was the donor biliary stricture,which were treated efficiently by ENBD and/or EST later.Conclusion ERCP is a safe and effective approach for diagnosis and treatment of biliary-related complications after liver transplantation and should be considered as first step in the non-surgical management.