内镜治疗肝移植术后胆道并发症的疗效  

Safety and effectiveness of endoscopic treatment for biliary tract complications after liver transplantation

作　　者：肖丽娜 李骁[1] 耿冲[1] 王春晖[1] XIAO Lina;LI Xiao;GENG Chong;WANG Chunhui(Department of Gastroenterology,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院消化内科

出　　处：《中国普外基础与临床杂志》2020年第1期53-57,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨内镜治疗肝移植术后胆道并发症的安全性及有效性。方法纳入四川大学华西医院2009年1月至2018年12月期间肝移植术后因胆道并发症行内镜治疗的患者,回顾性分析患者的一般情况、胆道并发症类型、内镜治疗效果及内镜相关并发症发生情况。结果 57例胆道并发症患者中单纯胆管狭窄37例,单纯胆汁漏4例,胆管狭窄合并胆管结石/胆泥15例,胆管狭窄合并胆汁漏1例。行经内镜逆行胰胆管造影(ERCP)共112例次,其中十二指肠乳头插管成功112例次(100%),治疗成功100例次(89.3%),包括患者胆管狭窄得到改善、胆汁漏治愈及胆总管结石成功取出。ERCP相关总体并发症15例次(13.4%),其中以ERCP术后胰腺炎最常见(9.8%)。结论内镜治疗肝移植术后胆道并发症安全、有效,可作为首选治疗方法。Objective To explore the safety and effectiveness of endoscopic treatment for biliary tract complications after liver transplantation. Methods Patients who underwent endoscopic treatment for biliary tract complications after liver transplantation from January 2009 to December 2018 in West China Hospital were enrolled.Characteristics of patients, types of biliary tract complications, effectiveness of endoscopic treatment and endoscopic related complications were collected and analyzed. Results Among the 57 patients with biliary tract complications, 37 patients had biliary stricture alone, 4 patients had bile leak alone, 15 patients had biliary stricture plus biliary stones or sludge, and 1 patient had biliary stricture combined with biliary leakage. A total of 112 treatments of endoscopic retrograde cholangiopancreatography(ERCP) were performed, among which 100 treatments were accomplished successfully(89.3%), including the improvement of bile duct stenosis, the cure of bile leak and the successful removal of common bile duct stones. The number of total ERCP related complications was 15(13.4%), among which post ERCP pancreatitis was the most common(9.8%). Conclusion Endoscopic therapy can be considered as an initial treatment for biliary tract complications after liver transplantation as its safety and effectiveness.

关 键 词：内镜治疗 胆道并发症 肝移植 

分 类 号：R657.3[医药卫生—外科学]