超声检查在活体肝移植受体术后胆道并发症诊断中的应用

目的 探讨超声检查在活体肝移植术后胆道并发症诊断中的临床应用。方法 对21例成人右半肝活体移植受体术后进行超声检查,观察移植肝及其胆道声像图表现,与经皮经肝穿刺胆道造影引流(PTCD)等影像学结果相对比。结果 21例病例经PTCD及临床随访证实为胆管吻合口狭窄5例,胆泥1例,胆漏1例。超声检查能够诊断并与之相符5例,为4例吻合口狭窄及1例胆泥,胆漏病例可见肝周积液。其中4例胆管吻合口狭窄病例超声诊断时间均明显早于临床出现黄疸或血清胆红素升高的时间。结论 在活体肝移植术后胆道并发症的诊断中,超声检查操作简便、无创、可重复性强、准确性较高,可早期诊断胆管并发症,具有重要的临床应用价值。

Application of ultrasonography in evaluating biliary complications after living donor liver transplantation

Objective To investigate the clinical application of uhrasonography in the diagnosis of biliary complications after living donor liver transplantation （LDLT）. Methods Uhrasonography was used in 21 cases after right liver LDLT. The ultrasound images of transplanted liver and biliary tract were observed and compared with the result of percutaneous transhepatic cholangiography and drainage （PTCD）. Results Biliary complications were identified in 7 of the 21 cases by PTCD and clinical follow up. Anastomotic stricture was detected in 5 cases, bile leakage in 1 case, and bile sludge in 1 case. Five cases were accurately diagnosed by ultrasound, including 4 cases with anastomotic stricture and 1 case with bile sludge. Effusion surrounding liver was observed in the case with bile leakage by ultrasound. Moreover, the time when anastomotic stricture was diagnosed by ultrasound was earlier than that when jaundice appeared or serum bilirubin increased in 4 cases. Conclusions Ultrasonography is a method with convenience, non-invasion, strong repeatability and high accuracy in diagnosis of biliary complications at the early time after LI）LT, which has important value of clinical application.