肝移植术后胆管并发症内镜治疗进展  

Research advances in endoscopic treatment of biliary complications after liver transplantation

作　　者：徐辉 李冰 XU Hui, LI Bing(Department of Hepatology and Gastroenterology, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China)

机构地区：[1]首都医科大学附属北京佑安医院肝病消化中心,北京100069

出　　处：《临床肝胆病杂志》2018年第10期2245-2250,共6页Journal of Clinical Hepatology

摘　　要：肝移植仍然是目前终末期肝病或急性肝衰竭患者的最终治疗方案。随着器官保存、新型免疫抑制剂、围术期管理及肝胆外科技术的改善和发展,肝移植术后并发症的发生率已经显著减少,但是肝移植术后胆管并发症的治疗仍然面临诸多挑战,成为影响肝移植患者术后生活质量和生存时间的主要因素。肝移植术后胆管并发症包括胆管狭窄、吻合口漏和胆管结石等,治疗方法包括药物、内镜、肝穿刺胆管引流和手术等。随着内镜逆行胰胆管造影技术的飞速发展和广泛应用,操作的成功率高达90%~98%。因为内镜逆行胰胆管造影具有价格低、侵入性小、安全性相对较高等性价比优势,已经成为治疗肝移植术后胆管并发症的一线治疗方案。Liver transplantation remains the ultimate treatment regimen for patients with end-stage liver disease or acute liver failure. The incidence rate of biliary complications has significantly decreased with the improvement and development of organ preservation,novel immunosuppressants,perioperative management,and hepatobiliary surgery; however,there are still many challenges in the treatment of biliary complications after liver transplantation,which has become a major influencing factor for quality of life and survival time after liver transplantation. Biliary complications after liver transplantation include biliary stricture,anastomotic leakage,and cholelithiasis,and therapies include drugs,endoscopy,liver puncture and biliary drainage,and surgery. With the rapid development and wide use of endoscopic retrograde cholangiopancreatography（ ERCP） in recent years,the success rate of operation has reached as high as 90%-98%. Due to the advantages of low cost,low invasiveness,and relatively high safety,ERCP has become the first-line treatment of biliary complications after liver transplantation.

关 键 词：肝移植 手术后并发症 胰胆管造影术 内窥镜逆行 综述 

分 类 号：R617[医药卫生—外科学]