原位肝移植术后胆道并发症诊治134例

目的:探讨原位肝移植术后胆道并发症的预防和治疗.方法:回顾性分析2004-10/2006-01施行的134例肝移植患者的临床资料.结果:18例患者(共20例次)出现胆道并发症,治愈17例,1例放弃治疗.其中胆道狭窄12例次,胆漏2例次,胆管结石6例次.与T管相关的胆道并发症发生率为11.7%(14/120).胆道并发症组冷缺血时间(624min)和二次热缺血时间(60min)均高于无胆道并发症组(384min,43min,均P<0.05).结论:保存性损伤和缺血性损伤是肝移植术后胆道并发症的重要原因.术后早期胆道造影并联合应用核磁共振胆管成像有助于及时诊断胆道并发症.介入技术是胆道并发症的主要治疗手段.

Diagnosis and treatment of biliary complication after orthotopic liver transplantation: an analysis of 134 cases

AIM:To investigate the prevention and treat-ment of biliary complications after ortho-topic liver transplantation.METHODS:One hundred and thirty-four recipi-ents undergoing liver transplantation between October 2004 and January 2006 were retrospec-tively reviewed.RESULTS:Biliary complications occurred in 18 cases.Seventeen patients were cured,while 1 patient gave up treatment.Biliary strictures oc-curred in 12 cases,bile leakage in 2 cases,and cholothiasis in 6 cases.The incidence of bili-ary complications due to a T tube was 11.7%(14/120).Cold ischemic time and double hot ischemic time in the group of patients with bili-ary complications(624 minutes and 60 minutes,respectively)were longer than those in the group of patients without biliary complications(384 minutes and 43 minutes,respectively;both P < 0.05).CONCLUSION:The most important reason for biliary complications is preservative and isch-emic injury.Early cholangiography and MRI are helpful in the diagnosis of biliary complications.Treatment of biliary tract complications by inter-vention is effective.