留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肝移植术后胆道吻合口狭窄的诊疗进展

冯彦杰, 李敬东, 李强, 等. 肝移植术后胆道吻合口狭窄的诊疗进展[J]. 器官移植, 2024, 15(2): 297-302. doi: 10.3969/j.issn.1674-7445.2023240
引用本文: 冯彦杰, 李敬东, 李强, 等. 肝移植术后胆道吻合口狭窄的诊疗进展[J]. 器官移植, 2024, 15(2): 297-302. doi: 10.3969/j.issn.1674-7445.2023240
Feng Yanjie, Li Jingdong, Li Qiang, et al. Progress in diagnosis and treatment of biliary anastomotic stricture after liver transplantation[J]. ORGAN TRANSPLANTATION, 2024, 15(2): 297-302. doi: 10.3969/j.issn.1674-7445.2023240
Citation: Feng Yanjie, Li Jingdong, Li Qiang, et al. Progress in diagnosis and treatment of biliary anastomotic stricture after liver transplantation[J]. ORGAN TRANSPLANTATION, 2024, 15(2): 297-302. doi: 10.3969/j.issn.1674-7445.2023240

肝移植术后胆道吻合口狭窄的诊疗进展

doi: 10.3969/j.issn.1674-7445.2023240
基金项目: 国家卫生健康委医药卫生科技发展研究项目(WA2021RW26);川北医学院附属医院科研发展计划项目(2021YS004)
详细信息
    作者简介:
    通讯作者:

    李敬东(ORCID 0000-0002-1923-1787),教授,博士研究生导师,主任医师,研究方向为肝胆良恶性疾病,Email:lijingdong358@126.com

  • 中图分类号: R617, R575

Progress in diagnosis and treatment of biliary anastomotic stricture after liver transplantation

More Information
    Corresponding author: Li Jingdong, Email: lijingdong358@126.com
  • 摘要: 近年来,随着器官保存、手术技术、围手术期管理及免疫抑制方案的发展,肝移植手术成功率和受者生存率明显提高,已成为终末期肝病患者的最佳治疗方案。但胆道并发症依然是肝移植术后常见的并发症,尤其是胆道吻合口狭窄,严重的胆道吻合口狭窄不仅会增加治疗成本,还会导致移植物丢失,甚至影响受者生存率。因此,胆道吻合口狭窄的及时诊断和治疗对于提高肝移植术后受者生存率至关重要。本文就肝移植术后胆道吻合口狭窄的危险因素、临床症状、诊断及治疗进行综述,以期为肝移植术后胆道吻合口狭窄的研究和诊疗提供新的思路,进一步提高肝移植手术效果和受者生存质量。

     

  • FIG. 3003.  FIG. 3003.

    FIG. 3003..  FIG. 3003.

  • [1] KHALIL A, QUAGLIA A, GÉLAT P, et al. New developments and challenges in liver transplantation[J]. J Clin Med, 2023, 12(17): 5586. DOI: 10.3390/jcm12175586.
    [2] 孙大伟, 蒋文涛, 钟林, 等. 肝移植治疗肝内胆管细胞癌临床疗效的多中心研究[J]. 中华消化外科杂志, 2023, 22(2): 230-235. DOI: 10.3760/cma.j.cn115610-20221219-00753.

    SUN DW, JIANG WT, ZHONG L, et al. Clinical efficacy of liver transplantation for intrahepatic cholangiocarcinoma: a multicenter study[J]. Chin J Dig Surg, 2023, 22(2): 230-235. DOI: 10.3760/cma.j.cn115610-20221219-00753.
    [3] BOEVA I, KARAGYOZOV PI, TISHKOV I. Post-liver transplant biliary complications: current knowledge and therapeutic advances[J]. World J Hepatol, 2021, 13(1): 66-79. DOI: 10.4254/wjh.v13.i1.66.
    [4] TINGLE SJ, THOMPSON ER, ALI SS, et al. Risk factors and impact of early anastomotic biliary complications after liver transplantation: UK registry analysis[J]. BJS Open, 2021, 5(2): zrab019. DOI: 10.1093/bjsopen/zrab019.
    [5] MATAR AJ, ROSS-DRISCOLL K, KENNEY L, et al. Biliary complications following adult deceased donor liver transplantation: risk factors and implications at a high-volume US center[J]. Transplant Direct, 2021, 7(10): e754. DOI: 10.1097/TXD.0000000000001207.
    [6] 韦金铭, 冯啸, 曾凯宁, 等. 儿童劈离式肝移植的胆管分型与重建[J]. 器官移植, 2022, 13(6): 791-796. DOI: 10.3969/j.issn.1674-7445.2022.06.015.

    WEI JM, FENG X, ZENG KN, et al. Classification and reconstruction of bile duct in pediatric split liver transplantation[J]. Organ Transplant, 2022, 13(6): 791-796. DOI: 10.3969/j.issn.1674-7445.2022.06.015.
    [7] PRIETO M, VALDIVIESO A, GASTACA M, et al. Hepaticojejunostomy in orthotopic liver transplant: a retrospective case control study[J]. Transplant Proc, 2019, 51(1): 58-61. DOI: 10.1016/j.transproceed.2018.03.135.
    [8] ESLAMI O, MOAZZAMI B, ZABALA ZE, et al. Anastomotic biliary stricture following liver transplantation and management analysis: 15 years of experience at a high-volume transplant center[J]. Indian J Gastroenterol, 2022, 41(3): 231-239. DOI: 10.1007/s12664-022-01245-4.
    [9] SAXENA R, GHOSH NK, GALODHA S. Economics and safety of continuous and interrupted suture hepaticojejunostomy: an audit of 556 surgeries[J]. Ann Hepatobiliary Pancreat Surg, 2021, 25(4): 472-476. DOI: 10.14701/ahbps.2021.25.4.472.
    [10] 杜晓东. 不同类型缝线对成人肝移植术后胆道并发症的影响[D]. 吉林: 吉林大学, 2021.
    [11] TORIIGAHARA Y, MATSUURA T, YANAGI Y, et al. The advantages of duct-to-duct biliary reconstruction in pediatric living donor liver transplantation[J]. Pediatr Surg Int, 2023, 39(1): 286. DOI: 10.1007/s00383-023-05568-x.
    [12] 徐曼曼, 武羽, 李珊珊, 等. 不同预后评分在慢加急性肝衰竭肝移植决策中的应用[J]. 中华肝脏病杂志, 2023, 31(6): 574-581. DOI: 10.3760/cma.j.cn501113-20230202-00031.

    XU MM, WU Y, LI SS, et al. Application of different prognostic scores in liver transplantation decision-making for acute-on-chronic liver failure[J]. Chin J Hepatol, 2023, 31(6): 574-581. DOI: 10.3760/cma.j.cn501113-20230202-00031.
    [13] BOTAN E, GÜN E, GÜNEŞ SA, et al. Early period intensive care follow-up after liver transplantation in children: a single center experience[J]. Turk J Pediatr, 2023, 65(3): 489-499. DOI: 10.24953/turkjped.2022.743.
    [14] DUMORTIER J, CHAMBON-AUGOYARD C, GUILLAUD O, et al. Anastomotic bilio-biliary stricture after adult liver transplantation: a retrospective study over 20 years in a single center[J]. Clin Res Hepatol Gastroenterol, 2020, 44(4): 564-571. DOI: 10.1016/j.clinre.2019.08.008.
    [15] UMUGWANEZA N, BYIRINGIRO F, NDAHIMANA P, et al. Unusual anatomical variations of the hepatic arteries and bile ducts: what are the surgical implications[J]. Afr Health Sci, 2022, 22(3): 697-702. DOI: 10.4314/ahs.v22i3.74.
    [16] KALDAS FM, KORAYEM IM, RUSSELL TA, et al. Assessment of anastomotic biliary complications in adult patients undergoing high-acuity liver transplant[J]. JAMA Surg, 2019, 154(5): 431-439. DOI: 10.1001/jamasurg.2018.5527.
    [17] CHIKKALA BR, RAHUL R, AGARWAL S, et al. Outcomes of right and left hepatic arterial anastomosis in right lobe living donor liver transplant[J]. Exp Clin Transplant, 2022, 20(2): 157-163. DOI: 10.6002/ect.2020.0309.
    [18] KHUBUTIYA MS, KURENKOV AV, TETERIN YS, et al. Endoscopic intraluminal treatment of early biliary complications after orthotopic liver transplantation[J]. Khirurgiia (Mosk), 2023(8): 13-19. DOI: 10.17116/hirurgia202308113.
    [19] WANG L, YANG B, JIANG H, et al. Individualized biliary reconstruction techniques in liver transplantation: five years' experience of a single institution[J]. J Gastrointest Surg, 2023, 27(6): 1188-1196. DOI: 10.1007/s11605-023-05657-1.
    [20] KARAKOYUN R, ERICZON BG, KAR I, et al. Risk factors for development of biliary stricture after liver transplant in adult patients: a single-center retrospective study[J]. Transplant Proc, 2021, 53(10): 3007-3015. DOI: 10.1016/j.transproceed.2021.09.023.
    [21] KARB D, SATYAVADA S, SHAH R, et al. Post-liver transplant lymphoproliferative disorder presenting as biliary stricture[J]. ACG Case Rep J, 2021, 8(7): e00628. DOI: 10.14309/crj.0000000000000628.
    [22] MEIER RPH, KELLY Y, BRAUN H, et al. Comparison of biliary complications rates after brain death, donation after circulatory death, and living-donor liver transplantation: a single-center cohort study[J]. Transpl Int, 2022, 35: 10855. DOI: 10.3389/ti.2022.10855.
    [23] 刘大群, 孙晓东, 邱伟, 等. 影响肝移植术后胆管吻合口狭窄的相关因素分析[J]. 中华消化外科杂志, 2022, 21(2): 249-255. DOI: 10.3760/cma.j.cn115610-20211129-00602.

    LIU DQ, SUN XD, QIU W, et al. Analysis of influencing factors for anastomotic biliary stricture after liver transplantation[J]. Chin J Dig Surg, 2022, 21(2): 249-255. DOI: 10.3760/cma.j.cn115610-20211129-00602.
    [24] FASULLO M, SHAH T, ZHOU H, et al. Post-transplant biliary strictures: an updated review[J]. Semin Liver Dis, 2022, 42(2): 225-232. DOI: 10.1055/s-0042-1744144.
    [25] ATTWELL A, HAN S, KRISS M. Endoscopic retrograde cholangiopancreatography and liver biopsy in the evaluation of elevated liver function tests after liver transplantation[J]. World J Hepatol, 2021, 13(1): 132-143. DOI: 10.4254/wjh.v13.i1.132.
    [26] SANYAL R, LALL CG, LAMBA R, et al. Orthotopic liver transplantation: reversible Doppler US findings in the immediate postoperative period[J]. Radiographics, 2012, 32(1): 199-211. DOI: 10.1148/rg.321115006.
    [27] WANG CK, CHENG YF, CHEN CL, et al. Imaging diagnosis of biliary complications of ABO incompatibility in living donor liver transplantation[J]. Transplant Proc, 2020, 52(6): 1833-1837. DOI: 10.1016/j.transproceed.2020.02.133.
    [28] MARTINS FP, SELETI SMR, CONTINI ML, et al. Is there a place for cholangioscopic evaluation of biliary anastomotic stricture after deceased donor liver transplant?[J]. Arq Gastroenterol, 2020, 57(4): 347-353. DOI: 10.1590/S0004-2803.202000000-67.
    [29] BOWEN H, WENZHI G, PEIHAO W, et al. The reasonable therapeutic modality for biliary duct-to-duct anastomotic stricture after liver transplantation: ERCP or PTC?[J]. Front Oncol, 2022, 12: 1035722. DOI: 10.3389/fonc.2022.1035722.
    [30] 田文杰, 董鼎辉, 郝杰, 等. 原位肝移植术后胆道吻合口狭窄的综合微创治疗效果: 单中心60例分析[J]. 器官移植, 2022, 13(5): 597-604. DOI: 10.3969/j.issn.1674-7445.2022.05.008.

    TIAN WJ, DONG DH, HAO J, et al. Comprehensive minimally invasive treatment for biliary anastomotic stenosis after orthotopic liver transplantation: a single center analysis of 60 cases[J]. Organ Transplant, 2022, 13(5): 597-604. DOI: 10.3969/j.issn.1674-7445.2022.05.008.
    [31] KOHLI DR, HARRISON ME, MUJAHED T, et al. Outcomes of endoscopic therapy in donation after cardiac death liver transplant biliary strictures[J]. HPB (Oxford), 2020, 22(7): 979-986. DOI: 10.1016/j.hpb.2019.10.018.
    [32] CANTÙ P, TARANTINO I, BALDAN A, et al. Endo-therapies for biliary duct-to-duct anastomotic stricture after liver transplantation: outcomes of a nationwide survey[J]. Liver Int, 2019, 39(7): 1355-1362. DOI: 10.1111/liv.14010.
    [33] CANTÙ P, SANTI G, ROSA R, et al. Cost analysis of a long-term randomized controlled study in biliary duct-to-duct anastomotic stricture after liver transplantation[J]. Transpl Int, 2021, 34(5): 825-834. DOI: 10.1111/tri.13867.
    [34] WARNER B, HARRISON P, FARMAN M, et al. A unique type of fully covered metal stent for the management of post liver transplant biliary anastomotic strictures[J]. BMC Gastroenterol, 2020, 20(1): 329. DOI: 10.1186/s12876-020-01479-6.
    [35] AHMED W, KYLE D, KHANNA A, et al. Intraductal fully covered self-expanding metal stents in the management of post-liver transplant anastomotic strictures: a UK wide experience[J]. Therap Adv Gastroenterol, 2022, 15: 17562848221122473. DOI: 10.1177/17562848221122473.
    [36] CANAKIS A, GILMAN AJ, BARON TH. Management of biliary complications in liver transplant recipients using a fully covered self-expandable metal stent with antimigration features[J]. Minerva Gastroenterol (Torino), 2023,DOI: 10.23736/S2724-5985.23.03343-0[Epub ahead of print
    [37] SHARMA ZD, KARUNAKARAN M, BANSAL RK, et al. Cholangioscopic classification of post-living donor liver transplantation biliary strictures can predict their natural history and response to therapy[J]. ANZ J Surg, 2023, 93(4): 911-917. DOI: 10.1111/ans.18123.
    [38] FRANZINI T, SAGAE VMT, GUEDES HG, et al. Cholangioscopy-guided steroid injection for refractory post liver transplant anastomotic strictures: a rescue case series[J]. Ther Adv Gastrointest Endosc, 2019, 12: 2631774519867786. DOI: 10.1177/2631774519867786.
    [39] RÖNNING J, BERGLUND E, ARNELO U, et al. Long-term outcome of endoscopic and percutaneous transhepatic approaches for biliary complications in liver transplant recipients[J]. Transplant Direct, 2019, 5(3): e432. DOI: 10.1097/TXD.0000000000000869.
    [40] RASEKHI A, GHOLAMI Z, AZIZI M, et al. Percutaneous transhepatic radiologic intervention of biliary complications following liver transplantation: a single-center experience[J]. Int J Organ Transplant Med, 2022, 13(2): 38-47.
    [41] KIM KS, KIM JM, LEE JS, et al. Long-term outcome of the rendezvous technique in patients with severe biliary anastomotic stricture that cannot cannulate after liver transplant[J]. Transplant Proc, 2020, 52(6): 1812-1817. DOI: 10.1016/j.transproceed.2020.02.137.
    [42] ÖDEMIŞ B, BAŞPINAR B, TOLA M, et al. Magnetic compression anastomosis is a good treatment option for patients with completely obstructed benign biliary strictures: a case series study[J]. Dig Dis Sci, 2022, 67(10): 4906-4918. DOI: 10.1007/s10620-022-07381-3.
    [43] LEE AY, LEHRMAN ED, PERITO ER, et al. Non-operative management of biliary complications after liver transplantation in pediatric patients: a 30-year experience[J]. Pediatr Transplant, 2021, 25(6): e14028. DOI: 10.1111/petr.14028.
  • 加载中
图(1)
计量
  • 文章访问数:  283
  • HTML全文浏览量:  102
  • PDF下载量:  46
  • 被引次数: 0
出版历程
  • 收稿日期:  2023-11-08
  • 网络出版日期:  2024-01-05
  • 刊出日期:  2024-03-15

目录

    /

    返回文章
    返回