肝移植术后并发症的介入治疗

目的评价肝移植术后多种并发症的介入治疗。方法回顾性的分析肝移植术后出现各种并发症并进行介入治疗的82例患者,胆管病变62例;肝动脉病变8例;下腔静脉病变13例;肝静脉狭窄7例;门静脉病变9例。胆管并发症采用经T管置入引流管、经皮肝穿刺胆管行胆汁引流或球囊扩张术。球囊扩张成形术或(和)金属支架植入术处理血管狭窄的患者;局部溶栓治疗用于术后血管内血栓形成的病例。结果在胆管并发症患者中,41例经T管置入引流管,34例行经皮穿刺胆汁引流(PTBD),球囊扩张胆道成形术9例。3例肝动脉狭窄的患者接受了球囊扩张成形术或支架植入术,1例肝动脉形成血栓者行插管溶栓,效果良好。9例下腔静脉狭窄患者行支架植入术,1例接受了球囊扩张成形术。5例肝静脉狭窄患者接受了球囊扩张成形术或支架治疗。门静脉狭窄患者中6例接受支架治疗,1例门脉血栓形成行局部溶栓,治疗不满意。结论介入治疗是处理肝移植术后胆管和血管并发症不可或缺的临床治疗方法。

Interventional treatment for complications after liver transplantation

Objective To evaluate the application of interventional radiology for the complications after liver transplanta-tion.Methods Eighty-two patients with varies complications after liver transplantationfromJul 1999 to Jun 2005 were an-alyzed respectively.One case may have one or more complications and receive one or more interventional therapies.In thisgroup,62 cases with bile duct diseases;hepatic artery 8 cases;inferior vena cava 13 cases;hepatic vein 7 case;portal vein9 cases.The bile duct complications mainly were treated with biliary drainage through Ttube,percutaneous biliary drain-age(PTBD) and balloon dilatation;percutaneous transluminal angioplasty(PTA) and/or metallic stents were applied forhepatic artery stenosis,inferior vena cava strictures,hepatic vein or portal vein stenosis.Results There were 41 cases ofextra drainage through Ttube,PTBD 34 cases,balloon dilation 9 cases for patients with bile duct diseases.Three caseswith hepatic artery stenosis were treated with PTAor stents;one case withthrombosis received transcatheter thrombolysisand recently effect was well done.Nine patients withinferior vena cava strictures were successfully treated with stents andone received a single balloon dilatation,it was satisfactory.PTAor stents was used in 5 cases of hepatic vein stenosis,iti mproved flowof the vascular.In 9 portal vein cases,6 cases with stenosis received stents,1 case treated withthrombolys-is for thrombosis was poor.Conclusion The interventional radiology technique is a indispensable method for the complica-tions after liver transplantationin clinic.