ERCP及PTC介入治疗肝移植术后胆道并发症作用比较.docVIP

ERCP及PTC介入治疗肝移植术后胆道并发症作用比较 　 作者：易述红 陆敏强 杨扬 蔡常洁 王卫东 郑丰平 单鸿 姜在波 【摘要】 目的 比较ERCP和PTC介入治疗肝移植术后胆道并发症的作用和疗效。方法 回顾性分析2004年8月至2006年8月44例接受介入治疗的肝移植术后胆道并发症患者临床资料，比较ERCP和PTC介入治疗在肝移植术后胆道并发症中的疗效和并发症。结果 首选ERCP介入治疗31例，3例操作失败(9.6%)；PTC介入治疗16例，均操作成功。胆道吻合口狭窄和非胆道吻合口狭窄ERCP和PTC介入治疗的治愈率分别为73.3%、77.7%和23.1%、14.3%，差异无统计学意义(Pgt;0.05)。两种介入治疗术后并发症的发生率差异无统计学意义(Pgt;0.05)。结论 ERCP和PTC介入治疗肝移植术后胆道并发症的疗效和并发症的发生率相当，可以将PTC介入技术作为治疗肝移植术后胆道并发症的首选措施。 【关键词】 肝移植； 胆道并发症； 介入治疗； ERCP； PTC 【Abstract】 Objective To compare the curative effect of ERCP and PTC in the treatment of biliary complications after liver transplantation. Methods A retrospective analysis was carried out on data of 44 patients who received interventional therapy for biliary complications following liver transplantation from August 2004 to August 2006 to compare therapeutic effect of ERCP and PTC in treating biliary complications. Results Of 31 patients treated by ERCP, three failed, with failure rate of 9.6%, and then they were conversed to PTC treatment. While all of 16 patients treated by PTC obtained satisfactory outcome. The healing rate of ERCP for anastomotic biliary stricture (ABS) and nonanastomotic biliary stricture (NABS) was 73.3% and 77.7% respectively, while that of PTC for ABS and NABS was 23.1% and 14.3% respectively, with no statistical difference (Pgt;0.05). The incidence of complications after ERCP and PTC had no statistical difference (Pgt;0.05). Conclusions Efficacy and complications incidence of ERCP for biliary complications following liver transplantation is comparable to PTC. PTC can be used as the primary treatment for biliary complications following liver transplantation. 　　【Key words】 Liver transplantation; Biliary complication; Interventional therapy; ERCP; PTC 随着微创医学的发展和成熟，ERCP和PTC介入技术已广泛应用于肝移植术后胆道并发症的诊治中。本文总结我中心2004年8月至2006年8月44例肝移植患者的临床资料，比较ERCP、PTC介入治疗肝移植术后胆道并发症的疗效和并发症。 　　1 临床资料 　　1.1 一般资料 肝移植术后出现胆道并发症患者44例，其中男42例，女2例；平均年龄(48.5±10.1)岁(32～67岁)。44例均为尸体供肝全肝移植，其中1例为再移植。原发疾病中肝炎后肝硬化16例，原发性肝癌13例，慢性重症乙型肝炎12例，急性肝