肝移植术后胆泥及胆结石形成原因分析

目的 探讨肝移植术后胆泥和胆结石形成的原因。方法 对13例肝移植术后发生胆泥和／或胆结石的临床资料进行回顾性分析。结果 13例发生胆泥和／或胆结石的时间为1.5－12个月（平均5.5个月），供肝热缺血时间平均为5.5min，冷缺血时间11.5h；UW液经门静脉灌注；胆道冲洗时间在热缺血后15-20min；11例供肝动脉与受者的肝动脉吻合，2例与结肠中动脉吻合。结论 肝移植术后发生胆泥及胆结石有多种原因，其中主要是缺血、灌注损伤及肝动脉供血不足。

The causes of biliary sludge and bilestone formation after liver transplantation

Objective　To investigate the causes of biliary sludge and bilestone formation after liver transplantation. Methods　The clinical data of 13 cases of biliary sludge and(or) bilestone complications after liver transplantation were analyzed retrospectively. Results　Among these patients, the biliary sludge and bilestone formation occurred in the average of 5.5 months (from 1.5 to 12 months) with the mean warm and cold ischemic time being 5.5 min and 11.5!h respectively. Donor livers were perfused and preserved by UW solution through portal vein. Biliary tract was washed 15～20 min after the warm ischemia. Donor hepatic artery was anastomosed with recipient hepatic artery in 11 cases, with colon middle artery in 2 cases. Conclusions　Many causes are responsible for the biliary sludge and bilestone formation after liver transplantation. The main causes include the ischemia-reperfusion injury and inadequate blood supply of hepatic artery.