摘要
目的 探讨肝移植术后胆道并发症的预防、诊断和治疗。 方法 对 1993年 4月～2 0 0 1年 11月我科实施的 12 3例肝移植患者临床资料进行回顾性分析。 结果 12 3例肝移植患者中11例通过胆道造影确诊为肝移植术后胆道并发症 ,9例治愈 ,1例好转 ,死亡 1例。胆道并发症发生率为 8 9% ( 11/ 12 3) ,与胆道并发症相关的死亡率为 0 8% ( 1/ 12 3) ,与T管相关的胆道并发症发生率为4 2 % ( 5 / 119) ,与肝动脉供血相关的胆道并发症发生率为 1 6 % ( 2 / 12 3)。热缺血时间 >3min、冷缺血时间 >8h组胆道并发症发生率明显升高 (P <0 0 5 )。 结论 保存性损伤和缺血性损伤是肝移植术后胆道并发症的重要原因。修肝时应维护肝外胆管的血供和警惕变异胆管的存在。改进T管置管方法可显著降低与T管相关的胆道并发症发生率。术后早期胆道造影有助于及时诊断胆道并发症。介入技术是胆道并发症的主要治疗手段。
Objective To study the prevention, diagnosis and treatment of biliary complications after liver transplantation. Methods One hundred and twenty-three recipients who had received liver transplantation between April 1993 and November 2001 were retrospectively reviewed. Results Biliary complication was diagnosed cholangiography^ically in 11 patients. Nine patients were cured, 1 patient was improved and 1 patient died. The incidence for biliary complications was 8.9% (11/123), and the mortality was 0.8%(1/123). The incidence of biliary complications due to T tube was 4.2%(5/119). The incidence of biliary complications due to hepatic artery was 1.6%(2/123). In recipients with WIT>3 min and CIT>8 h, the incidence of biliary complications elevated significantly. Conclusions The most important reason for biliary complications was preservative and ischemic injury. While repairing donor liver, damage to the blood supply system of donor liver bile ducts should be avoided. Meticulous T tube placement may reduce the incidence of biliary complications. Early cholangiography is helpful to diagnose biliary complications.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2003年第1期3-5,共3页
Chinese Journal of Surgery
关键词
肝移植
手术后并发症
预防
诊断
治疗
Liver transplantation
Postoperative complications
Biliary
Prevention
Diagnosis
Treatment
