肝移植术后胆道并发症的治疗

陈 晓帅1, 王志 鑫*2
1、青海大学研究生院
2、青海大学附属医院肝胆胰外科

摘要


胆道并发症是肝移植后最常见的并发症。由于肝移植数量增加和移植患者生存期延长，这些并发症更常见。
胆道并发症仍然是肝移植患者发病的主要来源，发病率为5%-32%。肝移植后胆道并发症包括狭窄（吻合口和非吻合
口）、渗漏、结石、Oddi括约肌功能障碍以及原发性胆道疾病复发，例如原发性硬化性胆管炎和原发性胆汁性肝硬化。
发生特定胆道并发症的风险与肝移植时进行的胆道重建类型有关。

关键词


肝移植；并发症；胆道

全文:

PDF


参考


[1]中华医学会器官移植学分会.中国肝移植术后并

发症诊疗规范（2019版）[J].器官移植，2021，12（2）：

129-133.

[2]Qian YB, Liu CL, Lo CM, Fan ST. Risk factors for

biliarycomplications after liver transplantation. Arch Surg

2004; 139:1101-1105 [PMID: 15492152 DOI: 10.1001/

archsurg.139.10.1101].

[3]Welling TH, Heidt DG, Englesbe MJ, Magee JC,

Sung RS,Campbell DA, Punch JD, Pelletier SJ. Biliary

complicationsfollowing liver transplantation in the model

for end-stage liver disease era: effect of donor, recipient,

and technical factors. LiverTranspl 2008; 14: 73-80 [PMID:

18161843 DOI: 10.1002/lt.21354].

[4]Greif F, Bronsther OL, Van Thiel DH, Casavilla

A, Iwatsuki S, Tzakis A, Todo S, Fung JJ, Starzl TE.

The incidence, timing,and management of biliary tract

complications after orthotopic liver transplantation. Ann Surg

1994; 219: 40-45.

[5]Davidson BR, Rai R, Kurzawinski TR, Selves L,

Farouk M,Dooley JS, Burroughs AK, Rolles K. Prospective

randomized trial of end-to-end versus side-to-side biliary

reconstruction after orthotopic liver transplantation. Br J Surg

1999; 86:447-452.

[6]Pascher A, Neuhaus P. Biliary complications

after deceased-donor orthotopic liver transplantation. J

Hepatobiliary PancreatSurg 2006; 13: 487-496.

[7]Scatton O, Meunier B, Cherqui D, Boillot O,

Sauvanet A,Boudjema K, Launois B, Fagniez PL, Belghiti

J, Wolff P,Houssin D, Soubrane O. Randomized trial of

choledochoch oledochostomy with or without a T tube in

orthotopic livertransplantation. Ann Surg 2001; 233: 432-

437.

[8]Vanatta JM, Dean AG, Hathaway DK, Nair S,

Modanlou KA,Campos L, Nezakatgoo N, Satapathy SK,

Eason JD. Liver transplant using donors after cardiac death:

a single-center approach providing outcomes comparable

to donation after brain death.Exp Clin Transplant 2013; 11:

154-163 [PMID: 23480344 DOI:10.6002/ect.2012.0173].

[9]Sharma S, Gurakar A, Jabbour N. Biliary strictures

following liver transplantation: past, present and preventive

strategies. Liver Transpl 2008; 14:759-769[PMID:18508368

DOI:10.1002/lt.21509].

[10]Kitazono MT, Qayyum A, Yeh BM, Chard PS,

Ostroff JW,Coakley FV. Magnetic resonance cholangiography

of biliarystrictures after liver transplantation: a prospective

double-blind study. J Magn Reson Imaging 2007; 25: 1168-

1173 [PMID:17520726 DOI: 10.1002/jmri.20927].

[11]Akamatsu N, Sugawara Y, Hashimoto D. Biliary

reconstruction,its complications and management of biliary

complications afteradult liver transplantation: a systematic

review of the incidence,risk factors and outcome. Transpl Int

2011; 24: 379-392 [PMID:21143651 DOI: 10.1111/j.1432-

2277.2010.01202.x.

[12]Londoño MC, Balderramo D, Cárdenas A.

Management of biliary complications after orthotopic liver

transplantation:the role of endoscopy. World J Gastroenterol

2008; 14: 493-497[PMID: 18203278].

[13]Thuluvath PJ, Pfau PR, Kimmey MB, Ginsberg

GG. Biliarycomplications after liver transplantation: therole of

endos-copy.Endoscopy2005;37:857-863[PMID:16116539.

DOI:10.1055/s-2005-870192].

[14]Morelli J, Mulcahy HE, Willner IR, Baliga P,

Chavin KD, Patel R, Payne M, Cotton PB, Hawes R,

Reuben A, CunninghamJT. Endoscopic treatment of postliver transplantation biliary leaks with stent placement across

the leak site. GastrointestEndosc 2001; 54: 471-475.

[15]Sherman S, Shaked A, Cryer HM, Goldstein LI,

Busuttil RW.Endoscopic management of biliary fistulas

complicating liver transplantation and other hepatobiliary

operations. Ann Surg.1993; 218: 167-175.

[16]Dumonceau JM, Tringali A, Blero D, Devière J,

Laugiers R,Heresbach D, Costamagna G. Biliary stenting:

indications, choice of stents and results: European Society

of Gastrointestinal Endoscopy(ESGE) clinical guideline.

Endoscopy 2012; 44: 277-298 [PMID:22297801 DOI:

10.1055/s-0031-1291633.

[17]Verdonk RC, Buis CI, Porte RJ, van der Jagt EJ,

Limburg AJ, van den Berg AP, Slooff MJ, Peeters PM, de

Jong KP,Kleibeuker JH, Haagsma EB. Anastomotic biliary

stricturesafter liver transplantation: causes and consequences.

Liver Transpl 2006; 12: 726-735.

[18]Alazmi WM, Fogel EL, Watkins JL, McHenry

L, Tector JA,Fridell J, Mosler P, Sherman S, Lehman GA.

Recurrence rate of anastomotic biliary strictures in patients

who have had previous successful endoscopic therapy for

anastomoticnarrowing after orthotopic liver transplantation.

Endoscopy2006; 38: 571-574.

[19]Kao D, Zepeda-Gomez S, Tandon P, Bain VG.

Managing the post- liver transplantation anastomotic biliary

stricture: multiple plastic versus metal stents: a systematic

review. Gastrointest Endosc 2013;77: 679-691 [PMID:

23473000 DOI: 10.1016/j.gie.2013.01.015.


Refbacks

  • 当前没有refback。