原位肝移植术中应用T型管重建胆管的近期相关并发症

目的 研究同种异体肝移植术中应用T型管重建胆管的相关并发症。方法 回顾性分析2000年7月至2005年2月间135例患者肝移植术中应用T型管重建胆管的临床资料，总结其相关并发症的类型，并探讨减少并发症的方法。结果 135例患者肝移植术后共发生T型管相关性并发症9例，发生率为6．7％，其中发生拔除T管后腹膜炎5例；术后胆漏2例；T型管脱落2例。几乎所有患者拔除的T型管管腔均可见胆泥形成。结论 原位肝移植术中应用T型管重建胆管可以引起较高的胆管并发症发生率，因此不使用T型管是值得探讨和提倡的。

T-Tube related biliary complications in choledochocholedochostomy of orthotopic liver transplantation

Objective To study the incidence of biliary complications after liver transplantation in patients undergoing choledochocholedochostomy with a T tube. Methods A respective study with the data of 151 liver transplanttions was done in the 3rd Teaching Hospital of Peking University during July 2000 to February 2005. 135 liver transplantations with T tube were performed when choledochocholedochostomy was completed. The main types of T tube-related complications and the methods of reducing the biliary complications in liver transplantation were reported. Results Nine cases (6. 7 %) of T tube-related biliary complications were observed in 135 liver transplantations: including 5 cases of biliary peritonitis after removal of the T tube, 2 cases of postoperative bile leakage and 2 cases of dislocation of T tubes. Sludge formation could be found in all removed T tubes. Conclusions The use of T tube during liver transplantation seems to be disadvantage. Systematic use of T tube is not advisable.