Biliary occlusive disease after liver transplantation with endoscopic retrograde cholangiopancreatography plus percutaneous transhepatic cholangiodrainage
10.3760/cma.j.cn421203-20201119-00393
- VernacularTitle:ERCP联合PTCD胆道会师术治疗肝移植后胆道闭塞
- Author:
Rui SHI
1
;
Guang CHEN
;
Zirong LIU
;
Haijun GAO
;
Yamin ZHANG
Author Information
1. 天津市第一中心医院肝胆外科 300192
- Keywords:
Liver transplantation;
Biliary occlusion;
Endoscopic retrograde cholangiopancreatography
- From:
Chinese Journal of Organ Transplantation
2021;42(7):413-416
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy ofendoscopic retrograde cholangiopancreatography (ERCP) plus percutaneous transhepatic cholangiodrainage (PTCD) of biliary reunion in the treatment of biliary occlusion after liver transplantation.Methods:From May 2018 to August 2019, clinical data were retrospectively analyzed for 9 patients with biliary tract occlusion after an initial liver transplantation. All of them underwent biliary reunion. An endoscopist performed ERCP while an interventional physician completed PTCD with bilateral guide wire under the same anesthetic period so that bilateral guide wire completed a reunion at biliary occlusion for re-opening biliary tract or establishing a new bile duct outflow path. Postoperative follow-ups were performed for observing the treatment outcomes and various factors of biliary stricture factors analyzed.Results:All of them received PTCD or T-tube sinus angiography and interventional treatment. The diagnosis of complete biliary occlusion was definite. After treatment, 7 cases of biliary tract reunion were successful. During operation, three reunion types of guide wire biliary, intestinal cavity and intra-abdominal cavity were employed. Two failed cases received continuous PTCD drainage after operation. The influencing factors of biliary tract stenosis were retrospectively analyzed after operation. Among them, there were non-anastomotic stenosis ( n=2), biliary leakage ( n=2) and anastomotic stenosis and long tortuous biliary tract ( n=5). Conclusions:Rapid, mini-invasive and safe, ERCP plus PTCD biliary tract reunion may be employed as a first choice for biliary occlusion after liver transplantation.
