内镜下逆行胰胆管造影对肝移植术后胆道并发症的诊疗作用(附12例报告)

目的 评价内镜下逆行胰胆管造影(ERCP)对肝移植术后胆道并发症的诊断和治疗价值。方法 应用电子十二指肠镜对原位肝移植术后疑有胆道并发症(梗阻性黄疸)的12例患者进行ERCP。结果 显示胆总管狭窄(梗阻)9例(伴胆总管结石2例),胆总管结石2例(伴胆总管扩张1例),移植肝肝内胆管变细1例。内镜下作胆总管气囊扩张、取石、放置金属胆总管内支架1例,Oddi括约肌切开取石3例,留置鼻胆管引流2例。结论 ERCP可作为原位肝移植术后胆道并发症诊断和治疗的主要手段,而且对大多数肝移植术后病人是安全有效的。

Diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography for biliary complications after liver transplantation: report of 12 cases

Objective To evaluate the diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography (ERCP) for biliary complications after liver transplantation. Methed ERCP was performed via electronic duodenoscopy in 12 patients suspected of having biliary complications such as obstructive jaundice after orthotopic liver transplantation. Results ERCP displayed common bile duct stenosis or obstruction in 9 cases (including 2 cases with also calculi), common bile duct calculi in 2 cases (including 1 complicated by bile duct dilation) and intrahepatic bile duct thinning in the donor liver in 1 case. Balloon dilation of the common bile duct, calculus removal and metal stent placement in the common bile duct was performed in one case. Calculus removal by Oddi sphincterotomy was carried out in 3 cases. Nasobiliary catheter placement was performed in 2 cases. Conclusion ERCP may serve as the primary modality for diagnosing and treating biliary complications after orthotopic liver transplantation with good safety and effectiveness in most cases.