肝移植术中不留置T型管指征的探讨

目的 探讨肝移植术中不留置T型管,以降低与T管相关胆道并发症的发生率.方法 对2004年1月至2006年10月的肝移植患者进行前瞻性临床研究.在此期间内符合指征未留置T管的患者102例,观察本组患者胆道并发症的发生率.结果 本组患者均随访6个月以上.胆道并发症的发生率是4.9%(5/102),其中3例为肝内胆管多发性狭窄,均行再次肝移植;2例为肝总管非吻合口狭窄,经ERCP行球囊扩张并放置胆道内支撑管3个月后治愈.结论 对符合指征的肝移植患者术中不留置T管是安全的,可避免T管相关并发症,降低胆道总体并发症的发生率.

Biliary tract reconstruction without T-tube in orthotopic liver transplantation

Objective To probe the indication of biliary tract reconstruction without T-tube in orthotopic liver transplantation.Methods We put forward indications of biliary tract reconstruction without T-tube in orthotopic liver transplantation since January 2004 and there were 102 patients who underwent liver transplantation in our hospital without a T-tube in place after biliary tract reconstruction.The incidence of biliary tract complication was observed in these patients.Results All patients were followed up for more than 6 months.The incidence of biliary tract complication was 4.9 percent(5/102)in this group with 3 patients of intrahepatic difluse bile duct stenosis necessitating liver re-transplantation.The other 2 patients with common hepatic duct nonanastomotic stenosis were healed by ERCP plus stent placement.Conclusions Biliary tract reconstruction without T-tube placement helps to decrease the incidence of biliary tract complications resulting from the T-tube removal.