肝移植术后胆管并发症的内镜治疗价值

目的评估肝移植术后胆管并发症内镜治疗的临床价值。方法我院从2001年3月至2006年10月进行的45例肝移植中,术后出现胆管并发症16例,其中胆漏1例,胆管狭窄8例,胆管狭窄并胆管结石2例。11例接受了内镜介入治疗计14次,包括内镜下放置鼻胆管外引流4例,放置支架内引流10例,气囊扩张10例,乳头括约肌小切开7例,乳头括约肌切开加取石2例。结果1例因内镜治疗时导丝无法通过狭窄段,改行PTC放置胆管支架,其余胆管并发症经内镜介入治疗有效。结论ERCP有助于肝移植术后胆管并发症诊断,治疗有效、安全,是肝移植术后胆管并发症首选治疗方法。

The effect of endoscopic therapy for biliary tract complications after original liver transplantation

Objective To evaluate the effect of ERCP for biliary tract complications after original liver transplantation(OLT).Methods Sixteen patients presented with biliary tract complications after OLT from March 2001 to October 2006 were reviewed.The complications included biliary leakage(1 case),biliary tract stricture(8 cases),biliary tract stricture accompanying biliary tract stone(2 cases).Eleven patients(8 men and 3 women,average age 39.5 years)underwent ERCP.Fourteen operations were performed,including ENBD(94 cases),biliary stents for drainage(10 cases),papillary balloon dilation(10 cases),endoscopic sphincterotomy(7 cases),and endoscopic sphincterotomy with stone removal(2 cases).Result In one case,since the ERCP wire cannot pass through biliary tract stricture,PTC was performed instead.The endoscopic therapy for biliary leakage,biliary tract stricture,biliary tract stone were clinically satisfactory.Conclusion Endoscopic management is effect and safe in solving biliary tract complications after OLT.