李初俊大夫的个人网站 lichujun.haodf.com

本站已经通过实名认证,所有内容由李初俊大夫本人发表

当前位置: 中山六院 > 李初俊 > 文章列表 >内镜下逆行胰胆管造影对肝移植术后胆道并发症的诊疗作用

学术论文

内镜下逆行胰胆管造影对肝移植术后胆道并发症的诊疗作用

发表者:李初俊 人已读

内镜下逆行胰胆管造影对肝移植术后胆道并发症的诊疗作用(12例报告)中山大学附属第六医院消化内镜中心李初俊
陈俊忠  崔毅  李初俊 

摘 要:

<目的>评价内镜下逆行胰胆管造影(ERCP)对肝移植术后胆道并发症的诊断和治疗价值.

<方法>应用电子十二指肠镜对原位肝移植术后疑有胆道并发症(梗阻性黄疸)12例患者进行ERCP.

<结果>显示胆总管狭窄(梗阻)9(伴胆总管结石2),胆总管结石2(伴胆总管扩张1),移植肝肝内胆管变细1.内镜下作胆总管气囊扩张、取石、放置金属胆总管内支架1,Oddi括约肌切开取石3,留置鼻胆管引流2.

<结论>ERCP可作为原位肝移植术后胆道并发症诊断和治疗的主要手段,而且对大多数肝移植术后病人是安全有效的.

 

关键词:内镜下逆行胰胆管造影;肝移植;胆道并发症

 

Diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography for biliary complications after liver transplantation: report of 12 cases
CHEN Jun-zhong
CUI Yi LI Chu-jun 

 

Abstract

To evaluate the diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography (ERCP) for biliary complications after liver transplantation.

ERCP was performed via electronic duodenoscopy in 12patients suspected of having biliary complications such as obstructive jaundice after orthotopic liver transplantation.

ERCP displayed common bile duct stenosis or obstruction in 9 cases (including 2 cases with also calculi),  common bile duct calculi in 2 cases (including 1 complicated by bile duct dilation) and intrahepatic bile duct thinning in the donor liver in 1 case. Balloon dilation of the common bile duct, calculus removal and metal stent placement in the common bile duct was performed in one case. Calculus removal by Oddi sphincterotomy was carried out in 3 cases. Nasobiliary catheter placement was performed in 2 cases.

ERCP may serve as the primary modality for diagnosing and treating biliary complications after orthotopic liver  transplantation with good safety and effectiveness in most cases.

 

Keywordsendoscopic retrograde cholangiopancreatography;  liver transplantation; biliary complication


References
1Miller CM, Schwartz ME, Emre S, et al. Operative techniques and strategies in liver transplantation[A]. In: Fabry TL, Klion FM, eds.Guide to liver transplantation [M]. New York: Igaku-shion, 1992,151-67.
2Spicak J, Ryska M, Trunecka P, et al. The role of ERCP in management of Biliary
complications after liver transplantation [J]. Ann Transplant, 2001, 6(2): 29-32.
3Anthony SB. ERCP in patients with liver transplants. In: Jacobson IM. ERCP and Its Applications [J]. Philadelphia: LippincottRaven Publishers, 1998: 151-8.
4Pfau PR, Kochman ML, Lewis JD, et al. Endoscopic management of postoperative biliary complications in orthotopic liver transplantation[J]. Gastrointest Endosc, 2000, 52(1): 55-63.
5Guitron A, Adalid R, Barinagarrementeria R, et al. Diagnostic and therapeutic endoscopic cholangiopancreatography in biliary leak after liver transplantation. Report of 2 cases [J]. Rev Gastroenterol Max, 2001, 66(1): 42-5.

 

 

 

Published2005620

---第一军医大学学报
JOURNAL OF FIRST MILITARY MEDICAL UNIVERSITY
2005 Vol.25 No.6 P.610-612

 

问医生

与医生电话交流 开始

网上免费问医生开始

预约就诊

发表于:2008-07-18 21:19

李初俊大夫的信息

  • 感谢信: 0 感谢信 礼物: 0 礼物
  • 贡献值: 0

李初俊大夫电话咨询

李初俊大夫已经开通电话咨询服务
直接与大夫本人通话,方便!快捷!

网上咨询李初俊大夫

李初俊的咨询范围: (精力有限,只回复与消化内镜诊疗相关问题;已咨询多位医生的患者不予回复)。消化内镜(胃镜、结肠镜、小肠镜、胶囊内镜、超声内镜、十二指肠镜)诊断和经内镜微创治疗相关问题。 更多>>

咨询李初俊大夫