肝移植术后胆泥形成9例报告

To discuss causes of biliary sludge formation after liver transplantation

关键词:  肝移植  胆道并发症  胆泥  缺血/再灌注损伤

Key words:  liver transplantation  biliary complications  biliary sludge  ischemia/reperfusion injury

摘要:

［目的］探讨肝移植术后胆泥形成的原因。［方法］ 对9例肝移植术后发生胆泥的临床资料进行回顾性分析。［结果］9例发生胆泥的时间为1.5～11个月，平均（4.8±2.69）个月，供肝热缺血时间为3～8 min ，平均(4.5±1.36) min，冷缺血时间为5～16 ｈ，平均(9.5±4.3)ｈ；胆道冲洗时间在热缺血后8～12 min，平均 (9.5±1.21) min；开放血流后0.5～4 min，平均（1.6±1.04） min供肝胆总管有胆汁排出。3例术后1个月内出现急性排斥反应。［结论］肝移植术后发生胆泥有多种原因，其中主要是缺血/再灌注损伤、肝动脉供血不足、胆道冲洗不充分及急性排斥反应等。

Abstract:

［Objective］To discuss the causes of biliary sludge formation after liver transplantation.［Methods］The clinical data of 9 cases of biliary sludge complication after liver transplantation was analyzed retrospectively.［Results］Among these patients,the biliare sludge formation occurred between 1.5 and 11 months (4.8±2.69) months with the mean warm and cold ischemic time being from 3 to 8 minutes (4.5±1.36) minutes and from 5 to 16 hours (9.5±4.3) hours respectively. Biliary tract was washed between 8 and 12 minutes (9.5±1.21) minutes after the warm ischemic. There was bile effusing from the bile duct of donor liver between 0.5 and 4 minutes (1.6±1.04) minutes after liver blood circulation opening. Three cases occurred acute cellular rejection within 1 month about post-operation.［Conclusion］There are a lot of causes about biliary sludge formation after liver transplantation,including ischemia reperfusion injury, insufficient blood supply to the bile duct,insufficient bile duct irrigation and acute rejection and so on.