Etiology and Endoscopic Treatment of Biliary Complications after Liver Transplantation(Report of 32 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 范林 ¹ , 涂强 ¹ , 乔兵兵 ¹ , 熊艳 ¹ , 李弦 ¹ ,  叶啟发 ^1,2

1. ;
2. ;

Corresponding author：

叶啟发, Email: yqf_china@163.com

Keywords：

肝移植; 胆道并发症; 病因; 内镜治疗

DOI：

10.7507/1007-9424.20140016

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探讨肝移植术后胆道并发症的病因及内镜在肝移植并发症中的治疗。方法笔者所在单位1995年9月至2010年3月期间共施行尸体肝移植516例，将其分为2个阶段，即1995～2001年的技术摸索阶段和2001～2010年的技术成熟阶段。第1阶段125例，有17例（13.60%）发生胆道并发症；第2阶段391例，有15例（3.84%）发生胆道并发症。对这32例患者行内镜诊治的相关临床资料进行回顾性分析。结果 32例中单纯胆瘘5例，单纯胆管结石2例，单纯胆管狭窄11例，胆管狭窄伴结石9例，胆管狭窄合并胆瘘2例，胆管扭曲2例，十二指肠乳头狭窄1例。针对不同的胆道并发症，采取了胆管扩张、乳头切开取石、胆道支架置放、鼻胆管引流等不同的治疗方式，32例患者共行内镜治疗56例次，治疗成功27例（84.38%）；发生内镜相关并发症4例（12.50%）。结论内镜治疗肝移植术后胆道并发症的疗效是值得肯定的。

Citation： 范林, 涂强, 乔兵兵, 熊艳, 李弦, 叶啟发. Etiology and Endoscopic Treatment of Biliary Complications after Liver Transplantation(Report of 32 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(1): 82-84. doi: 10.7507/1007-9424.20140016 Copy

1.	何炳均, 刘静静, 王劲, 等.肝移植术后胆道并发症的MRCP表现[J].中山大学学报:医学科学版, 2012, 33(1):132-133.
2.	Thethy S, Thomson BNj, Pleass H, et al.Management of biliary tract complications after orthotopic liver transplantation[J].Clin Transplant, 2004, 18(6):647-653.
3.	Hampe T, Dogan A, Encke J, et al.Biliary complications after liver transplantation[J].Clin Transplant, 2006, 20 Suppl 17:93-96.
4.	Kochhar G, Parungao JM, Hanouneh IA, et al.Biliary complications following liver transplantation[J].World J Gastroenterol, 2013, 19(19):2841-2846.
5.	黄文峰, 张小玲, 谢志军, 等.肝移植的研究进展及常见并发症处理[J].中国组织工程研究, 2012, 16(5):176-177.
6.	汪根树, 陈规划, 陆敏强, 等.原位肝移植术后胆管狭窄的治疗(附43例报告)[J].中国实用外科杂志, 2006, 26(6):432-434.
7.	唐晓旭.肝移植术后胆管并发症的病因及治疗研究进展[J].人民军医, 2012, 55(4):209-210.
8.	董长城.肝移植术后胆道并发症的预防及治疗[J].亚太传统医药, 2010, 6(2):67-68.
9.	Guichelaar MM, Benson JT, Malinchoc M, et al.Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation[J].Am J Transplant, 2003, 3(7):885-890.
10.	Warner PR, Nester TA.ABO-incompatible solid-organ transplantation[J].Am J Clin Pathol, 2006, 125 Suppl:S87-S94.
11.	Harvala H, Stewart C, Muller K, et al.High risk of cytomegalovirus infection following solid organ transplantation despite prophylactic therapy[J].J Med Virol, 2013, 85(5):893-898.
12.	Verdonk RC, Buis CI, Pone RJ, et al.Biliary complications after liver transplantation:a review[J].Scand J Gastroenterol Suppl, 2006, (243):89-101.
13.	Beltran MM, Marugan RB, Oton E, et al.Accuracy of magneticresonance cholangiography in the evaluation of late biliary complications after orthotopic liver transplantation[J].Transplantation Proceedings, 2005, 37(9):3924-3925.
14.	Buis CI, Geuken E, Visser DS, et al.Ischemic-type biliary lesi-ons after human liver transplantation are preceded by abnormal bile composition[J].Eur J Gastroenterol Hepatol, 2006, 18(1):A51-A52.
15.	Kusano T, Randall HB, Roberts JP, et al.The use of stents for duct-to-duct anastomoses of biliary reconstruction in orthotopic liver transplantation[J].Hepatogastroenterology, 2005, 52(63):695-699.
16.	Ribeiro JB, Martins Fde S, Garcia JH, et al.Endoscopic management of biliary complications after liver transplantation[J].Arq Bras Cir Dig, 2012, 25(4):269-272.
17.	Luigiano C, Bassi M, Ferrara F, et al.Placement of a new fully covered self-expanding metal stent for postoperative biliary strictures and leaks not responding to plastic stenting[J].Surg Laparosc Endosc Percutan Tech, 2013, 23(2):159-162.
18.	Kurita A, Kodama Y, Minami R, et al.Endoscopic stent placement above the intact sphincter of Oddi for biliary strictures after living donor liver transplantation[J].J Gastroenterol, 2013, 48(9):1097-1104.

1. 何炳均, 刘静静, 王劲, 等.肝移植术后胆道并发症的MRCP表现[J].中山大学学报:医学科学版, 2012, 33(1):132-133.
2. Thethy S, Thomson BNj, Pleass H, et al.Management of biliary tract complications after orthotopic liver transplantation[J].Clin Transplant, 2004, 18(6):647-653.
3. Hampe T, Dogan A, Encke J, et al.Biliary complications after liver transplantation[J].Clin Transplant, 2006, 20 Suppl 17:93-96.
4. Kochhar G, Parungao JM, Hanouneh IA, et al.Biliary complications following liver transplantation[J].World J Gastroenterol, 2013, 19(19):2841-2846.
5. 黄文峰, 张小玲, 谢志军, 等.肝移植的研究进展及常见并发症处理[J].中国组织工程研究, 2012, 16(5):176-177.
6. 汪根树, 陈规划, 陆敏强, 等.原位肝移植术后胆管狭窄的治疗(附43例报告)[J].中国实用外科杂志, 2006, 26(6):432-434.
7. 唐晓旭.肝移植术后胆管并发症的病因及治疗研究进展[J].人民军医, 2012, 55(4):209-210.
8. 董长城.肝移植术后胆道并发症的预防及治疗[J].亚太传统医药, 2010, 6(2):67-68.
9. Guichelaar MM, Benson JT, Malinchoc M, et al.Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation[J].Am J Transplant, 2003, 3(7):885-890.
10. Warner PR, Nester TA.ABO-incompatible solid-organ transplantation[J].Am J Clin Pathol, 2006, 125 Suppl:S87-S94.
11. Harvala H, Stewart C, Muller K, et al.High risk of cytomegalovirus infection following solid organ transplantation despite prophylactic therapy[J].J Med Virol, 2013, 85(5):893-898.
12. Verdonk RC, Buis CI, Pone RJ, et al.Biliary complications after liver transplantation:a review[J].Scand J Gastroenterol Suppl, 2006, (243):89-101.
13. Beltran MM, Marugan RB, Oton E, et al.Accuracy of magneticresonance cholangiography in the evaluation of late biliary complications after orthotopic liver transplantation[J].Transplantation Proceedings, 2005, 37(9):3924-3925.
14. Buis CI, Geuken E, Visser DS, et al.Ischemic-type biliary lesi-ons after human liver transplantation are preceded by abnormal bile composition[J].Eur J Gastroenterol Hepatol, 2006, 18(1):A51-A52.
15. Kusano T, Randall HB, Roberts JP, et al.The use of stents for duct-to-duct anastomoses of biliary reconstruction in orthotopic liver transplantation[J].Hepatogastroenterology, 2005, 52(63):695-699.
16. Ribeiro JB, Martins Fde S, Garcia JH, et al.Endoscopic management of biliary complications after liver transplantation[J].Arq Bras Cir Dig, 2012, 25(4):269-272.
17. Luigiano C, Bassi M, Ferrara F, et al.Placement of a new fully covered self-expanding metal stent for postoperative biliary strictures and leaks not responding to plastic stenting[J].Surg Laparosc Endosc Percutan Tech, 2013, 23(2):159-162.
18. Kurita A, Kodama Y, Minami R, et al.Endoscopic stent placement above the intact sphincter of Oddi for biliary strictures after living donor liver transplantation[J].J Gastroenterol, 2013, 48(9):1097-1104.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Etiology and Endoscopic Treatment of Biliary Complications after Liver Transplantation(Report of 32 Cases)

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content