中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
11期
920-923
,共4页
汪根树%许长谋%何可可%郑丰平%姜在波%李华%许赤%易述红%张剑%杨扬%陈规划%单鸿
汪根樹%許長謀%何可可%鄭豐平%薑在波%李華%許赤%易述紅%張劍%楊颺%陳規劃%單鴻
왕근수%허장모%하가가%정봉평%강재파%리화%허적%역술홍%장검%양양%진규화%단홍
肝移植%胆管疾病%胆管造影术%胰胆管造影术,内窥镜逆行
肝移植%膽管疾病%膽管造影術%胰膽管造影術,內窺鏡逆行
간이식%담관질병%담관조영술%이담관조영술,내규경역행
Liver transplantation%Biliary duct diseases%Cholangiography%Cholangiopancreatography,endoscopic retrograde
目的 比较经皮肝穿刺胆管造影(percutaneous transhepatic cholangiography,PTC)和内镜逆行胆胰管造影(endoscopic retrograde cholangiopancreatography,ERCP)介入治疗肝移植术后胆管狭窄的疗效.方法 回顾性分析132例肝移植术后胆管狭窄经PTC(PTC组)和ERCP(ERCP组)介入治疗的疗效.99例接受经PTC介入治疗,59例接受经ERCP介入治疗,26例因ERCP介入治疗疗效不佳或失败转行PTC介入治疗.采用X2经验比较两者的手术成功率、并发症率、治愈率和有效率.结果 PTC组和ERCP组胆管狭窄的类型差异有统计学意义(P＜0.01),PTC组以非吻合口狭窄为主,ERCP组以吻合口狭窄为主；PTC介入手术成功率高于ERCP介入手术(100％比97％)(P＜0.01),并发症发生率低于ERCP介入手术(15％比39％)(P＜0.01),两组的总治愈率和有效率差异无统计学意义(32.3％比45.8％,94.9％比88.1％)(P＞0.05).PTC和ERCP介入治疗吻合口型、肝外型、肝门型和弥漫型胆管狭窄的治愈率和有效率差异无统计学意义(P＞0.05).结论 经PTC和ERCP介入治疗肝移植术后胆管狭窄的疗效相当,可作为肝移植术后胆管狭窄尤其是非吻合口狭窄的一线治疗方法.
目的 比較經皮肝穿刺膽管造影(percutaneous transhepatic cholangiography,PTC)和內鏡逆行膽胰管造影(endoscopic retrograde cholangiopancreatography,ERCP)介入治療肝移植術後膽管狹窄的療效.方法 迴顧性分析132例肝移植術後膽管狹窄經PTC(PTC組)和ERCP(ERCP組)介入治療的療效.99例接受經PTC介入治療,59例接受經ERCP介入治療,26例因ERCP介入治療療效不佳或失敗轉行PTC介入治療.採用X2經驗比較兩者的手術成功率、併髮癥率、治愈率和有效率.結果 PTC組和ERCP組膽管狹窄的類型差異有統計學意義(P＜0.01),PTC組以非吻閤口狹窄為主,ERCP組以吻閤口狹窄為主；PTC介入手術成功率高于ERCP介入手術(100％比97％)(P＜0.01),併髮癥髮生率低于ERCP介入手術(15％比39％)(P＜0.01),兩組的總治愈率和有效率差異無統計學意義(32.3％比45.8％,94.9％比88.1％)(P＞0.05).PTC和ERCP介入治療吻閤口型、肝外型、肝門型和瀰漫型膽管狹窄的治愈率和有效率差異無統計學意義(P＞0.05).結論 經PTC和ERCP介入治療肝移植術後膽管狹窄的療效相噹,可作為肝移植術後膽管狹窄尤其是非吻閤口狹窄的一線治療方法.
목적 비교경피간천자담관조영(percutaneous transhepatic cholangiography,PTC)화내경역행담이관조영(endoscopic retrograde cholangiopancreatography,ERCP)개입치료간이식술후담관협착적료효.방법 회고성분석132례간이식술후담관협착경PTC(PTC조)화ERCP(ERCP조)개입치료적료효.99례접수경PTC개입치료,59례접수경ERCP개입치료,26례인ERCP개입치료료효불가혹실패전행PTC개입치료.채용X2경험비교량자적수술성공솔、병발증솔、치유솔화유효솔.결과 PTC조화ERCP조담관협착적류형차이유통계학의의(P＜0.01),PTC조이비문합구협착위주,ERCP조이문합구협착위주；PTC개입수술성공솔고우ERCP개입수술(100％비97％)(P＜0.01),병발증발생솔저우ERCP개입수술(15％비39％)(P＜0.01),량조적총치유솔화유효솔차이무통계학의의(32.3％비45.8％,94.9％비88.1％)(P＞0.05).PTC화ERCP개입치료문합구형、간외형、간문형화미만형담관협착적치유솔화유효솔차이무통계학의의(P＞0.05).결론 경PTC화ERCP개입치료간이식술후담관협착적료효상당,가작위간이식술후담관협착우기시비문합구협착적일선치료방법.
Objective To compare the efficacy of percutaneous and endoscopic treatment for the biliary stricture(BS) after liver transplantation (LT).Methods The result of percutaneous transhepatic cholangiography (PTC) and drainage ( PTC group) and endoscopic retrograde cholangiopancreatography (ERCP group) for the BS in 132 post-LT patients were analyzed retrospectively.Ninety-nine patients received PTC treatment,and 59 patients received ERCP treatment,26 patients converted to PTC treatment because of the poor efficacy or failure of the ERCP treatment.The operation success rate,complication rate,cure rate and remission rate of the two groups were compared with X2 test.Results The BS types of PTC and ERCP group were different significantly( P ＜ 0.01 ),with more non-anostomotic stricture in PTC group and more anostomotic stricture in ERCP group.The operation success rate of PTC group was higher than of ERCP group( 100％ vs 97％ ) (P ＜0.01 ),and the complication rate of PTC group was lower than of ERCP group.The overall cure and remission rate of PTC and ERCP group were not different significantly(32.3％ vs 45.8％,94.9％ vs 88.1％ ) (P ＞0.05).The cure and remission rate of PTC and ERCP treatment for each subtype of BS were not different significantly ( P ＞ 0.05 ).Conclusions The efficacy of PTC treatment for the post-LT BS is equivalent to that of ERCP treatment.PTC can be considered the first-line option for the post-LT BS.
