ERCP和PTC介入治疗肝移植术后胆道并发症的作用比较  

Comparison of efficacy of ERCP and PTC in treatment of biliary complications following liver transplantation

作　　者：易述红[1] 陆敏强[1] 杨扬[1] 蔡常洁[1] 王卫东[4] 郑丰平[2] 单鸿[3] 姜在波[3] 许赤[1] 李华[1] 易慧敏[1] 汪根树[1] 陈规划[1] 

机构地区：[1]中山大学附属第三医院肝脏移植中心、中山大学器官移植研究所,广州510630 [2]中山大学附属第三医院消化科、中山大学器官移植研究所,广州510630 [3]中山大学附属第三医院介入科、中山大学器官移植研究所,广州510630 [4]广东省人民医院肝胆外科,广州510080

出　　处：《中华消化外科杂志》2007年第5期337-339,共3页Chinese Journal of Digestive Surgery

基　　金：国家重点基础研究发展计划（973课题）项目基金（2003CD515507）;广东省医学科研基金（A2006218）

摘　　要：目的比较ERCP和PTC介入治疗肝移植术后胆道并发症的作用和疗效。方法回顾性分析2004年8月至2006年8月44例接受介入治疗的肝移植术后胆道并发症患者临床资料，比较ERCP和PTC介入治疗在肝移植术后胆道并发症中的疗效和并发症。结果首选ERCP介入治疗31例，3例操作失败（9．6％）；PTC介入治疗16例，均操作成功。胆道吻合口狭窄和非胆道吻合口狭窄ERCP和PTC介入治疗的治愈率分别为73．3％、77．7％和23．1％、14．3％，差异无统计学意义（P〉0．05）。两种介入治疗术后并发症的发生率差异无统计学意义（P〉0．05）。结论ERCP和PTC介入治疗肝移植术后胆道并发症的疗效和并发症的发生率相当，可以将PTC介入技术作为治疗肝移植术后胆道并发症的首选措施。Objective To compare the curative effect of ERCP and PTC in the treatment of biliary complications after liver transplantation. Methods A retrospective analysis was carried out on data of 44 patients who received interventional therapy for biliary complications following liver transplantation from August 2004 to August 2006 to compare therapeutic effect of ERCP and PTC in treating biliary complications. Results Of 31 patients treated by ERCP, three failed, with failure rate of 9.6%, and then they were conversed to PTC treatment. While all of 16 patients treated by PTC obtained satisfactory outcome. The healing rate of ERCP for anastomotic biliary stricture （ABS） and non-anastomotic biliary stricture （NABS） was 73.3% and 77.7% respectively, while that of PTC for ABS and NABS was 23.1% and 14.3% respectively, with no statistical difference （ P 〉0.05 ）. The incidence of complications after ERCP and PTC had no statistical difference （ P 〉 0.05）. Conclusions Efficacy and complications incidence of ERCP for biliary complications following liver transplantation is comparable to PTC. PTC can be used as the primary treatment for biliary complications following liver transplantation.

关 键 词：肝移植 胆道并发症 介入治疗 ERCP PTC 

分 类 号：R686[医药卫生—骨科学]