Perioperative management of endoscopic retrograde cholangiopancreatography in the treatment of biliary complications following liver transplantation
10.3877/cma.j.issn.2095-3232.2014.04.005
- VernacularTitle:内镜下逆行性胰胆管造影术治疗肝移植术后胆道并发症的围手术期管理
- Author:
Zhie WU
1
;
Ying LIN
;
Jin TAO
;
Yanping LIANG
;
Fengping ZHENG
Author Information
1. 中山大学附属第三医院消化内镜中心
- Keywords:
Liver transplantation;
Biliary complication;
Cholangiopancreatography,endoscopic retrograde;
Perioperative care
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2014;(4):215-218
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the perioperative management of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of biliary complications following liver transplantation (LT). Methods A total of 102 patients with biliary complications following LT undergoing ERCP in Digestive Endoscopy Center, the Third Afifliated Hospital of Sun Yat-sen University from December 2008 to December 2012 were included in this prospective study. There were 90 males and 12 females with the age ranging from 23 to 65 years old and a median of 56 years old. The informed consents of all patients were obtained and the ethical committee approval was received. Positive preoperative preparations were given to the patients:personalized psychological counseling, strict disinfection of surgical instruments, application of preoperative drugs, et al. The operators and nursing staff cooperated closely during the operation. Symptomatic treatments such as fasting, transfusion, anti-infection, antacids, somatostatin were given to the patients after operation. The nasobiliary ducts were properly ifxed and the conditions were closely observed. Health guidance was given to the patients after hospital discharge. Results In 102 patients, 94 patients were treated by ERCP successfully with the success rate of 92.2% (94/102). The curative rate was 77%(72/94), the improvement rate was 20%(19/94) and the total effective rate was 97%(91/94). Postoperative complications were observed in 15 cases including hyperamylasemia (n=8), mild pancreatitis (n=4), bleeding of the papillary muscles incision (n=3), and all were cured by conservative treatments. Conclusions Positive preoperative psychological counseling, close collaboration of medical staff during the operation, close observation on the postoperative complications and health guidance after hospital discharge are important factors for the success of ERCP in treating biliary complications following LT.
