肝移植术后胆管狭窄的早期介入处理技巧

目的探讨肝移植术后带T管期间胆管狭窄的早期诊断及介入治疗价值。方法回顾性分析85例患者肝移植术后胆管狭窄资料,所有病例均经T管途径实施了介入治疗,包括换管、扩张(直接扩张、球囊及金属扩张器扩张)、支撑引流(单管、双管、三管引流)以及胆道镜观察和疏通。结果65例胆管狭窄疗效满意(有效率76%),10例得到控制,6例效果较差,接受了二次肝移植,4例治疗无效死亡。结论经T管途径的胆道造影和介入治疗是早期发现和控制胆管狭窄简单而有效的诊治方法。

Role of the early interventional treatment of biliary stricture after liver transplantation

Objective To study the early imaging diagnosis and evaluate interventional treatment of biliary stricture after orthotopic liver transplantation from T-tube.Methods A retrospective review of the 250 cases within T-tube periods after liver transplantation and T-tube cholangiography were carried out for all cases. The biliary strictures in 85 cases (85/250, the incidence being 34%) were confirmed. From the T-tube road, interventional treatments (including direct dilation and drainage, single or double or three catheters drainage, biliary balloon dilation, percutaneous transhepatic cholangiography and drainage etc. were carried out for the patients with the biliary strictures.Result Sixty-five cases of the biliary strictures were cured (the curative rate being 76 %), 10 turned better, 6 were failed and subsequently received liver retransplantation, and 4 died.Conclusion Biliary cholangiography and interventional procedures from the T-tube play the most important roles in the early diagnoses and treatment of the biliary strictures after liver transplantation.