肝移植术后胆道吻合口狭窄内镜处理策略  

Endoscopic retrograde cholangiography in management of biliary stoma stenostomia after liver transplantation.

作　　者：龚彪[1] 于凤海[2] 张薇[2] 叶萍[2] 别里克[1] 王田田[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化科,上海200025 [2]第二军医大学附属东方肝胆外科医院内镜科,上海200438

出　　处：《中国实用内科杂志》2008年第10期858-859,共2页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨肝移植术后胆道吻合口狭窄的内镜处理和操作技巧。方法分析第二军医大学附属东方肝胆外科医院内镜科2003年12月至2006年12月经十二指肠镜治疗的228例肝移植患者临床资料。结果肝移植术后胆道并发症患者中,合并或单纯胆道吻合口病变者187例,占82.0%,其中175例成功进行了内镜下治疗,成功率93.6%。187例有胆道吻合口病变的患者中,吻合口狭窄149例(79.7%),其中成功进行内镜下逆行胰胆管造影(ERCP)治疗者145例,成功率为97.3%。结论肝移植后胆道并发症患者中,合并或单纯胆道吻合口狭窄者占绝大多数,ERCP是诊断和治疗肝移植术后胆道并发症的首选方法之一。行ERCP时导丝及其他附件通过胆道吻合口狭窄的操作技巧是治疗成功的关键。Objective To investigate the roles of endoscopic retrograde cholangiography in management of biliary stoma stenostomia after liver transplantation. Methods A retrospective analysis was conducted of 228 patients who had underwent ERC after liver transplantation. Results The result showed that 187 out of 228 patients after liver transplantation had biliary stoma affection （82. 0% ）. In these 187 patients, 175 had accepted the treatment of endoscopic retrograde cholangiography successfully（93.6% ）. Also in these 187 patients, 149 had biliary stoma stenostomia and 145 accepted the treatment of endoscopic retrograde cholangiography successfully （97. 3% ）. Conclusion Endoscopic retrograde cholangiography is one of the primary methods for the diagnosis and treatment of biliary stoma stenostomia after liver transplantation. In addition,the technique of endoscopic retrograde cholangiography is crucial to these patients.

关 键 词：肝移植 胆道吻合口狭窄 内镜下逆行胰胆管造影 

分 类 号：R5[医药卫生—内科学]