成人原位肝移植术后常见胆道并发症的诊疗  

Diagnosis and treatment of common biliary complications after orthotopic liver transplantation in adults

作　　者：胡鑫文 李亭[1] Hu Xinwen;Li Ting(Department of Liver Transplantation,Transplant Medicine Research Center,the Second Xiangya Hospital of Central South University,Changsha 430011,China)

机构地区：[1]中南大学湘雅二医院肝脏移植科移植医学研究中心,长沙430011

出　　处：《器官移植》2022年第5期569-576,共8页Organ Transplantation

基　　金：湖南省自然科学基金(2022JJ30816);长沙市自然科学基金(kq2014237)。

摘　　要：肝移植已成为治疗终末期肝病的有效方法,由于外科技术、供者选择、器官保存和运输、免疫抑制药、围手术期管理的长足发展,肝移植总体手术并发症明显下降,但胆道并发症发生率仍处于较高水平。当前,肝移植术后胆道并发症仍是导致移植物失功的重要原因,关于胆道并发症的发病机制及诊治仍存在争议,也是近年来器官移植领域的研究热点。本文尝试对成人原位肝移植术后胆道并发症的新突破和进展进行总结,为进一步解决胆道并发症相关临床问题提供理论基础。Liver transplantation has become an effective treatment for end-stage liver diseases. With rapid development of surgical techniques, donor selection, organ preservation and transportation, immunosuppressants and perioperative management, the overall incidence of complications after liver transplantation has been significantly decreased, whereas the incidence of biliary complications remains relatively high. At present, biliary complications after liver transplantation are still an important cause of graft failure. Nevertheless, the pathogenesis, diagnosis and treatment of biliary complications remain controversial, which are also research hotspots in the field of organ transplantation in recent years. In this article, new breakthrough and research progress upon biliary complications after orthotopic liver transplantation in adults were reviewed, aiming to provide theoretical basis for resolving biliary complications-related clinical issues.

关 键 词：原位肝移植 胆道并发症 胆道狭窄 胆漏 内镜逆行胰胆管成像(ERCP) 经皮穿刺肝胆道成像(PTC) 磁共振逆行胰胆管造影(MRCP) 全覆膜自膨式金属支架 

分 类 号：R617[医药卫生—外科学] R657.4[医药卫生—临床医学]