CAJ | 학술논문

目的：探讨肝移植术后非吻合口胆道狭窄的介入治疗方法及其疗效。方法回顾性分析2009年1月-2013年12月解放军第309医院共9例肝移植术后发生非吻合口胆道狭窄的临床资料，分别行经腋中线入路和剑突下入路建立2条引流道，行球囊扩张术和胆道引流术。结果9例均表现为肝内胆管多发狭窄合并胆泥形成，其中2例合并胆道吻合口狭窄，1例合并胆道吻合口瘘。2例治疗无效，黄疸指数渐进性增高，临床症状和体征未见明显缓解。7例好转，黄疸指数下降，临床症状和体征明显缓解。结论反复球囊扩张、分支多次引流、反复胆道塑形是肝移植术后胆道非吻合口狭窄的有效介入治疗方法。
목적：탐토간이식술후비문합구담도협착적개입치료방법급기료효。방법회고성분석2009년1월-2013년12월해방군제309의원공9례간이식술후발생비문합구담도협착적림상자료，분별행경액중선입로화검돌하입로건립2조인류도，행구낭확장술화담도인류술。결과9례균표현위간내담관다발협착합병담니형성，기중2례합병담도문합구협착，1례합병담도문합구루。2례치료무효，황달지수점진성증고，림상증상화체정미견명현완해。7례호전，황달지수하강，림상증상화체정명현완해。결론반복구낭확장、분지다차인류、반복담도소형시간이식술후담도비문합구협착적유효개입치료방법。
Objective To explore the interventional treatment methods in nonanastomotic biliary strictures after orthotopic liver transplantation and observe the effectiveness.Methods Clinical data about 9 cases with nonanastomotic biliary strictures after liver transplantation from January 2009 to December 2013 in the 309th Hospital of Chinese PLA were retrospectively analyzed and balloon dilatation and drainage were performed through axillary midline approach and xiphoid process in 9 cases.Results Of the 9 cases characterized by multiple narrow intrahepatic bile ducts merging with bile mud formation, 2 cases had anastomotic stenosis and 1 case had anastomotic fistula. The treatment in 2 cases was invalid with progressive jaundice index and no obviously alleviated clinical symptoms and signs were found. While, the treatment in the other 7 cases was effective with decreased jaundice index and obviously alleviated clinical symptoms and signs.Conclusion Repeated balloon dilatation, biliary drainage of branches several times and repeated biliary shaping are effective methods for nonanastomotic biliary strictures.