肝移植术后胆系并发症  

Biliary complications followed orthotopic liver transplantation

作　　者：王宝忠 K.J.Hardy R.M.Jones 

机构地区：[1]Australia,Melbourne3084,AustinHospital,LiverTransplantUnit

出　　处：《中华器官移植杂志》1997年第3期149-151,共3页Chinese Journal of Organ Transplantation

摘　　要：为探讨肝移植术后胆系并发症与移植术中胆道再建方式的关系,对100例次肝移植资料进行总结。70例次采用胆总管端端吻合法,30例次采用Roux-Y法(胆-肠吻合法)。前者术后共10例次发生胆系并发症,后者15例次发生胆系并发症,两者比较,差异显著。25例次胆系并发症中,14例为胆道狭窄。认为胆道狭窄与手术技术有关,另外,胆道血供受损、供肝冷缺血时间过长、保存期间胆汁的直接毒性作用、ABO血型不符以及排斥等均可导致胆道狭窄。采取器官储存前清除残余胆汁、UW液胆系灌注保护、保护动脉血运、缩短或消除胆道热缺血时间、改进操作方法等,可降低胆道狭窄的发生率。In order to investigate the correlation between the biliary complications and biliary reconstruction during the liver transplantation, the data of 100 cases undergoing orthotopic liver transplantation was summarized. Of 100 cases, 70 received biliary reconstruction with end-end anastomosis and 30 Roux-en-Y. It was found 10 cases was diagnosed having the complications in the former and 15 in the latter. Biliary complications were 25% which were defined as morbidity related to biliary reconstruction needing surgical or instrumental treatment, radiological evidence of duct narrowing or obstruction, or bile leakage. Complications were suspected on clinical, biological or microbiological evidence, and confirmed by cholangiography. The purposes of this study were to document the frequency of biliary complications and strictrues after orthotopic liver transplantation, and to examine associations with suspected risk factors.

关 键 词：肝移植 胆道疾病 并发症 

分 类 号：R657.405[医药卫生—外科学] R657.3[医药卫生—临床医学]