肝移植术后血管与胆管并发症的介入治疗

目的 评价介入方法诊断与治疗肝移植术后血管与胆管并发症的价值。方法对40例肝移植患者的相关资料进行回顾性分析。结果40例肝移植患者中有3例患者术后出现血管并发症，发病率为7．50％(3／40)，首发时间分别在术后4天、38天和80天。其中2例肝动脉狭窄植入支架，1例肝右动脉主干闭塞，但侧支循环形成未做治疗。2例患者术后出现胆总管吻合口狭窄，其中1例合并吻合口漏，发病率为5．00％(2／40)，首发时间分别在术后68天和100天。经皮肝穿胆道造影诊断后1例行内外引流，1例先行球囊扩张后植入胆道支架，黄疸均减轻。结论介入放射技术对于肝移植术后胆管与血管并发症的诊治具有很大价值。

Interventional therapy of vascular and biliary complications after liver transplantation

Objective To investigate the value of interventional radiology for the detection and treatment of vascular and biliary complications after liver transplantation. Methods Forty patients who underwent liver transplantation from August 1999 to August 2004 were retrospectively reviewed. Results Vascular complications were identified in 3 cases, with and incidence of 7.50%(3/40). The intervals between transplantation and clinical diagnosis were 4, 38, and 80 days, respectively. Two cases with hepatic artery stricture received balloon angioplasty and stent placement, with an incidence of 5.00%(2/40). One case with hepatic right artery stricture without treatment because of collateral circulation were formed. Anastomotic bile duct strictures were identified in 2 cases, included anastomotic bile leaks in 1 case. The intervals between transplantation and clinical diagnosis were 68 and 100 days, respectively. Jaundice decreased after percutaneous transhepatic cholangiography and drainage in 1 case. One case received balloon angioplasty and stent placement. Conclusion Interventional radiology techniques are valuable in the detection and treatment of vascular and biliary complications after liver transplantation.