Endoscopic diagnosis and treatment of biliary complications after liver transplantation: Clinical analysis of 250 times of procedures
- VernacularTitle:肝移植术后胆道并发症的内镜诊断和治疗(附250例次临床资料分析)
- Author:
Sheng CHEN
;
Weidong WANG
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
ERCP;
Biliary duct complication
- From:
Chinese Journal of Minimally Invasive Surgery
2005;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical value of endoscopic retrograde cholangiopancreatography(ERCP) in the diagnosis and treatment of biliary complications after orthotroptic liver transplangtation.Methods We retrospectively reviewed the clinical data of 139 patients with biliary complications after orthotropic liver transplangtation,and summarized 10 categories of biliary complications.The location of biliary complications included donor liver,anastomotic stoma,receptor biliary duct,duodenal papilla,and so on.Common complications were biliary duct or anastomotic strictures(102/139,73.4%),cholangitis(94/139,67.6%),common bile duct or intrahepatic cholelithiasis(75/139,54.0%),dysfunction of the duodenal papilla(20/139,14.4%),bile leakage(17/139,12.2%),and complications related to T-tube(4/139,2.9%).Infrequent complications involved duodenal papillary stenosis(1/139,0.7%),complications related to PTC(2/139,1.4%),biliary bleeding(3/139,2.2%),and too long and twisted bile duct(4/139,2.9%).The treatment methods included EST(112/139,80.6%),dilatable bougie or balloon dilatation(157/250,62.8%),plastic stent placement(139/250,55.6%),ENBD and irrigation(87/250,34.8%),and gallstone removal(27/250,10.8%).Results A total of 250 times of ERCP was performed in the 139 patients,the success rate of intubation being 99.2%(248/250).The total cure rate reached 70.5%(98/139) and the improvement rate was 18.7%(26/139),with a total effective rate of 89.2%(124/139).There were 9 patients with conversions to open surgery(9/139,6.5%),4 patients with no improvement(4/139,2.9%),and 2 patients with spontaneous quitting treatment or loss of follow-up.The postoperative complications included cholangitis in 37 patients,the dislodgement of ENBD tube in 26 patients,and biliary sludge or stone in 18 patients.Conclusions ERCP is an effective way to diagnose and treat the biliary complications after orthotroptic liver transplantation.
