肝移植术后胆道梗阻的治疗进展

doi:10.3877/cma.j.issn.1674-0793.2018.02.016

中华普通外科学文献(电子版) ›› 2018, Vol. 12 ›› Issue (02) : 133 -135. doi: 10.3877/cma.j.issn.1674-0793.2018.02.016

所属专题：文献；

综述

肝移植术后胆道梗阻的治疗进展

罗长江¹, 曹宏泰², 李龙¹, 焦作义²^,^†(

)

^1. 730030　兰州大学第二医院普外11科
^2. 730030　兰州大学第二医院普外1科

收稿日期:2017-10-09 出版日期:2018-04-01
通信作者: 焦作义
基金资助:
甘肃省、市、自治区科技项目(GZK-2016-33)

Progress in the treatment of biliary obstruction after liver transplantation

Changjiang Luo¹, Hongtai Cao², Long Li¹, Zuoyi Jiao²^,^†()

^1. The Eleventh Department of General Surgery, the Second Hospital Affiliated to Lanzhou University, Lanzhou 730030, China
^2. the First Department of General Surgery, the Second Hospital Affiliated to Lanzhou University, Lanzhou 730030, China

Received:2017-10-09 Published:2018-04-01
Corresponding author: Zuoyi Jiao
About author:
Corresponding author: Jiao Zuoyi, Email: 451601192@qq.com

全文 ( ) 下载PDF ( ) 导出引用

胆道梗阻是肝移植术后较为棘手的胆道并发症之一，发生率及病死率高，因此，预防和及时处理肝移植术后胆道梗阻对于患者长期生存至关重要。磁共振胆管造影成像（MRCP）作为一个可靠的无创性检测胆道并发症的工具，已经被广泛使用。内镜下逆行胰胆管造影（ERCP）是目前非手术治疗肝移植术后胆道梗阻的首选方式，内镜治疗和经皮肝穿刺胆管造影（PTC）治疗无效或梗阻症状较重者直接行手术治疗或再次肝移植。

关键词: 胆汁淤积, 肝移植, 胰胆管造影术，磁共振, 胰胆管造影术，内窥镜逆行

Biliary obstruction is one of the most important biliary complications after liver transplantation, with high incidence and high mortality. Prevention and timely treatment is very important for long-term survival of patients. Magnetic resonance cholangiography (MRCP), as a reliable and non-invasive tool for detecting biliary complications, has been widely accepted. Endoscopic retrograde cholangiopancreatography (ERCP) is the first choice for non-operative biliary obstruction after liver transplantation. The patients with invalid endoscopic treatment or severe obstruction symptom should have surgical therapy or liver re-transplantation.

Key words: Cholestasis, Liver transplantation, Cholangiopancreatography, magnetic resonance, Cholangiopancreatography, endoscopic retrograde

[1]	Togashi J, Akamastu N, Kokudo N. Living donor liver transplantation for hepatocellular carcinoma at the University of Tokyo Hospital[J]. Hepatobiliary Surg Nutr, 2016, 5(5): 399-407.
[2]	Khaderi S, Guiteau J, Cotton RT, et al. Role of liver transplantation in the management of hepatoblastoma in the pediatric population[J]. World J Transplant, 2014, 4(4): 294-298.
[3]	蒙建源，徐静，樊奇, 等. 肝移植术后胆道并发症危险因素的Meta分析[J].中华肝胆外科杂志, 2012, 18(11): 816-822.
[4]	Arain MA, Attam R, Freeman ML. Advances in endoscopic management of biliary tract complications after liver transplantation[J]. Liver Transpl, 2013, 19(5): 482-498.
[5]	Xu YB, Min ZG, Jiang HX, et al. Diagnostic value of magnetic resonance cholangiopancreatography for biliary complications in orthotopic liver transplantation: a meta-analysis[J]. Transplant Proc, 2013, 45(6): 2341-2346.
[6]	Jorgensen JE, Waljee AK, Volk ML, et al. Is MRCP equivalent to ERCP for diagnosing biliary obstruction in orthotopic liver transplant recipients? A meta-analysis[J]. Gastrointest Endosc, 2011, 73(5): 955-962.
[7]	Macías-Gómez C, Dumonceau JM. Endoscopic management of biliary complications after liver transplantation: An evidence-based review[J]. World J Gastrointest Endosc, 2015, 7(6): 606-616.
[8]	Sharma S, Gurakar A, Jabbour N. Biliary strictures following liver transplantation: past, present and preventive strategies[J]. Liver Transpl, 2008, 14(6): 759-769.
[9]	Martins FP, Kahaleh M, Ferrari AP. Management of liver transplantation biliary stricture: Results from a tertiary hospital[J]. World J Gastrointest Endosc, 2015, 7(7): 747-757.
[10]	罗振超，陈立言，陈剑尉, 等. 肝移植术后胆道并发症的处理：附258例报告[J]. 南方医科大学学报, 2014, 34(5): 709-712.
[11]	Kulaksiz H, Weiss KH, Gotthardt D, et al. Is stenting necessary after balloon dilation of post-transplantation biliary strictures? Results of a prospective comparative study[J]. Endoscopy, 2008, 40(9): 746-751.
[12]	阳文俊，覃山羽，姜海行, 等. 肝移植术后胆管吻合口狭窄内镜胆道支架治疗[J]. 中国内镜杂志, 2016, 22(7): 78-84.
[13]	Weber A, Prinz C, Gerngross C, et al. Long-term outcome of endoscopic and/or percutaneous transhepatic therapy in patients with biliary stricture after or thotopic liver transplantation[J]. J Gastroenterol, 2009, 44(12): 1195-1202.
[14]	Krok KL, Cárdenas A, Thuluvath PJ. Endoscopic management of biliary complications after liver transplantation[J]. Clin Liver Dis, 2010, 14(2): 359-371.
[15]	Kao D, Zepeda-Gomez S, Tandon P, et al. Managing the postliver transplantation anastomotic biliary stricture: multiple plastic versus metal stents: a systematic review[J]. Gastrointest Endosc, 2013, 77(5): 679-691.
[16]	Gwon DI, Sung KB, Ko GY, et al. Dual catheter placement technique for treatment of biliary anastomotic strictures after liver transplantation[J]. Liver Transpl, 2011, 17(2): 159-166.
[17]	李传云，刘源，赖威, 等. 肝移植术后胆道并发症的处理：附40例报道[J]. 器官移植, 2010, 1(3): 166-169.
[18]	Bhattacharjya S, Gunson BK, Mirza DF, et al. Delayed hepatic artery thrombosis in adult orthotopic liver transplantation—a 12-year experience[J]. Transplantation, 2001, 71(11): 1592-1596.
[19]	周尊强，张正筠，王书云, 等. 肝移植术后远期胆道并发症的诊断与治疗[J]. 器官移植, 2013, 4(6): 347-349, 366.

[1]	陈进宏. 腹腔镜活体供肝获取规范与创新[J/OL]. 中华普通外科学文献(电子版), 2024, 18(05): 324-324.
[2]	李博, 贾蓬勃, 李栋, 李小庆. ERCP与LCBDE治疗胆总管结石继发急性重症胆管炎的效果[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 60-63.
[3]	仲福顺, 余露, 范晓礼, 叶啟发. 肝移植治疗肝上皮样血管内皮瘤一例[J/OL]. 中华移植杂志(电子版), 2024, 18(05): 293-297.
[4]	刘冉佳, 崔向丽, 周效竹, 曲伟, 朱志军. 儿童肝移植受者健康相关生存质量评价的荟萃分析[J/OL]. 中华移植杂志(电子版), 2024, 18(05): 302-309.
[5]	贺健, 张骊, 王洪海, 蒋文涛. 肝移植术后脾功能亢进转归及治疗研究进展[J/OL]. 中华移植杂志(电子版), 2024, 18(05): 310-314.
[6]	胡宁宁, 赵延荣, 王栋, 王胜亮, 郭源. FMNL3与肝细胞癌肝移植受者预后的相关性研究[J/OL]. 中华移植杂志(电子版), 2024, 18(05): 283-288.
[7]	王淑贤, 张良灏, 王利君, 张慧, 郭源, 许传屾, 李志强, 蔡金贞, 解曼, 饶伟. 成人肝移植围手术期严重心血管事件危险因素分析及预测模型研究[J/OL]. 中华移植杂志(电子版), 2024, 18(04): 222-229.
[8]	黄建朋, 邹建强, 宗华. 肝移植术后腹壁疝诊治初步经验[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(04): 471-473.
[9]	傅斌生, 冯啸, 杨卿, 曾凯宁, 姚嘉, 唐晖, 刘剑戎, 魏绪霞, 易慧敏, 易述红, 陈规划, 杨扬. 脂肪变性供肝在成人劈离式肝移植中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 789-794.
[10]	魏志鸿, 刘建勇, 吴小雅, 杨芳, 吕立志, 江艺, 蔡秋程. 肝移植术后急性移植物抗宿主病的诊治（附四例报告）[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 846-851.
[11]	中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[12]	中华医学会器官移植学分会, 中华医学会外科学分会外科手术学学组, 中华医学会外科学分会移植学组, 华南劈离式肝移植联盟. 劈离式供肝儿童肝移植中国临床操作指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 593-601.
[13]	刘军, 丘文静, 孙方昊, 李松盈, 易述红, 傅斌生, 杨扬, 罗慧. 在体与离体劈离式肝移植在儿童肝移植中的应用比较[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 688-693.
[14]	黄金鑫, 陈佳骏, 王旋, 曲岩, 张晞文, 李甫. ERCP在胆胰合流异常患者诊治中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 699-704.
[15]	张红君, 郑博文, 廖梅, 任杰. 超声及超声造影在肝移植术后上腹部淋巴结良恶性鉴别诊断中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 562-567.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Progress in the treatment of biliary obstruction after liver transplantation

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Progress in the treatment of biliary obstruction after liver transplantation