肝移植术后血管与胆管并发症的介入治疗  

Interventional therapy of vascular and biliary complications after liver transplantation

作　　者：黄加胜[1] 闫东[1] 袁曙光[1] 李迎春[1] 王家平[1] 韩正林[1] 龚丽娜[1] 

机构地区：[1]昆明医学院第二附属医院放射科DSA室,云南昆明650101

出　　处：《中国介入影像与治疗学》2005年第3期187-189,共3页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的评价介入方法诊断与治疗肝移植术后血管与胆管并发症的价值。方法对40例肝移植患者的相关资料进行回顾性分析。结果40例肝移植患者中有3例患者术后出现血管并发症,发病率为7.50%(3/40),首发时间分别在术后4天、38天和80天。其中2例肝动脉狭窄植入支架,1例肝右动脉主干闭塞,但侧支循环形成未做治疗。2例患者术后出现胆总管吻合口狭窄,其中1例合并吻合口漏,发病率为5.00%(2/40),首发时间分别在术后68天和100天。经皮肝穿胆道造影诊断后1例行内外引流,1例先行球囊扩张后植入胆道支架,黄疸均减轻。结论介入放射技术对于肝移植术后胆管与血管并发症的诊治具有很大价值。Objective To investigate the value of interventional radiology for the detection and treatment of vascular and biliary complications after liver transplantation. Methods Forty patients who underwent liver transplantation from August 1999 to August 2004 were retrospectively reviewed. Results Vascular complications were identified in 3 cases, with and incidence of 7.50%(3/40). The intervals between transplantation and clinical diagnosis were 4, 38, and 80 days, respectively. Two cases with hepatic artery stricture received balloon angioplasty and stent placement, with an incidence of 5.00%(2/40). One case with hepatic right artery stricture without treatment because of collateral circulation were formed. Anastomotic bile duct strictures were identified in 2 cases, included anastomotic bile leaks in 1 case. The intervals between transplantation and clinical diagnosis were 68 and 100 days, respectively. Jaundice decreased after percutaneous transhepatic cholangiography and drainage in 1 case. One case received balloon angioplasty and stent placement. Conclusion Interventional radiology techniques are valuable in the detection and treatment of vascular and biliary complications after liver transplantation.

关 键 词：肝移植术后 胆管并发症 介入治疗 肝移植患者 血管并发症 胆道造影诊断 介入放射技术 诊断与治疗 回顾性分析 肝动脉狭窄 吻合口狭窄 介入方法 动脉主干 吻合口漏 内外引流 经皮肝穿 胆道支架 球囊扩张 发病率 胆总管 价值 

分 类 号：R657.3[医药卫生—外科学] R735.7[医药卫生—临床医学]