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| 内镜下多塑料支架置入治疗活体肝移植术后胆管狭窄 |
| 高道键,胡冰*,潘亚敏,王田田,吴军,杨小明,叶馨,陆蕊,王淑萍,时之梅,黄慧,王书智 |
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(第二军医大学东方肝胆外科医院内镜科,上海 200438
*通信作者) |
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| 摘要: |
| 目的 探讨内镜下多塑料支架置入治疗活体肝移植术后胆管狭窄的安全性与长期疗效。方法 2005年6月至2012年6月,共31例活体肝移植术后胆管狭窄患者接受内镜逆行胆胰管造影(ERCP)及多塑料支架置入治疗,记录内镜治疗技术成功率和ERCP相关并发症,对患者进行随访并观察支架维持时间、狭窄消除率和狭窄持续消除率。结果 ERCP证实单纯胆管吻合口狭窄22例,胆管吻合口狭窄合并胆漏9例。27例成功置入塑料支架,内镜治疗技术成功率为87.1%(27/31)。ERCP并发症包括急性胰腺炎1例,急性胆管炎2例,支架部分移位2例,无操作相关死亡发生,支架中位维持时间为9.6个月,狭窄消除率为95%(19/20),狭窄持续消除率为88.2%(15/17;随访5～43个月,中位随访期38个月)。 结论 内镜下多塑料支架置入治疗活体肝移植术后胆管狭窄是安全、有效的方法,其长期疗效满意,可成为活体肝移植术后胆管狭窄的一线治疗方法。 |
| 关键词: 内镜逆行胆胰管造影术 塑料支架 活体肝移植 胆管狭窄 |
| DOI：10.3724/SP.J.1008.2013.00247 |
| 投稿时间：2013-01-23修订日期：2013-03-01 |
| 基金项目: |
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| Endoscopic deployment of multiple plastic stents for biliary stricture after living donor liver transplantation |
| GAO Dao-jian,HU Bing*,PAN Ya-min,WANG Tian-tian,WU Jun,YANG Xiao-ming,YE Xin,LU Rui,WANG Shu-ping,SHI Zhi-mei,HUANG Hui,WANG Shu-zhi |
(Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
*Corresponding author.) |
| Abstract: |
| Objective To evaluate the safety and long-term outcomes of endoscopic deployment of multiple plastic stents for treatment of biliary stricture after living donor liver transplantation (LDLT). Methods Between June 2005 and June 2012, 31 patients with biliary strictures after LDLT received endoscopic retrograde cholangiopancreatography(ERCP) and multiple plastic stents placement. The technical success rate and ERCP-related complications were observed. The patients were followed up and the duration of stents treatment, stricture eliminating rate, and sustained clinical success rate were recorded. Results The ERCP findings revealed stricture in 22 cases and stricture plus leakage in 9. The endoscopic technical success rate was 87.1% (27/31). ERCP-related complications included acute pancreatitis in 1 case, acute cholangitis 2 and partial stent migration in 2. There were no procedure-related deaths. The median period from stent deployment to removal was 9.6 months. The stricture eliminating rate was 95% (19/20) and sustained clinical success rate was 88.2% (15/17) during a follow-up of 5-43 months (median 38 months). Conclusion Endoscopic deployment of multiple plastic stents is safe and effective for biliary stricture after LDLT, with acceptable long-term outcomes, and the method may be a first-line therapy option for biliary stricture after LDLT. |
| Key words: endoscopic retrograde cholangiopancteatography plastic stents living donor liver transplantation biliary stricture |
