1、肝移植后胆道并发症的超声诊断价值薄华颖，夏稻子，张宇虹大连医科大学附属第二医院超声科，辽宁省大连市 116027Diagnostic value of ultrasound for biliary complications after liver transplantationBo Hua-ying, Xia Dao-zi, Zhang Yu-hongDepartment of Ultrasound, Second Affiliated Hospital of Dalian Medical University, Dalian 116027, Liaoning Province, China
2、背景：肝移植后胆道并发症可引起移植后肝失功，超声是移植肝胆道并发症的重要检查手段之一。目的：探讨超声对肝移植后胆道并发症的诊断价值。方法：纳入 92 例肝移植患者，男 81 例，女 11 例，年龄 21-67 岁；其中同种异体原位肝移植 90 例，活体部分肝移植 2 例；胆道重建方式均为胆管-胆管端端吻合。回顾性分析肝移植后常规检查及彩色多普勒超声检查结果，着重分析患者有无胆漏、胆道狭窄、胆泥或胆石形成，部分患者于超声引导下穿刺引流。结果与结论：92 例患者中超声诊断肝移植后胆道并发症 14 例：胆漏 5 例；胆道狭窄 4 例，其中吻合口狭窄 2 例，非吻合口狭窄 2 例；4 例胆泥形成；1
3、例胆管结石。提示肝移植胆道并发症患者有特征性超声表现，超声对肝移植后胆道并发症的诊断有重要价值。中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程全文链接：关键词 ： 实验动物； 组织构建； 超声； 肝移植； 胆道并发症； 胆漏； 胆道狭窄； 胆泥； 胆石； Abstract：BACKGROUND: Biliary complications after liver transplantation can cause liver graft dysfunction. Ultrasound examination is o
4、ne of important diagnostic methods of biliary complications after liver transplantation.OBJECTIVE: To investigate the value of ultrasound in the diagnosis of biliary complications after liver transplantation.METHODS: A total of 92 patients after liver transplantation, including 81 males, 11 females,
5、 aged 21-67 years; allogenic orthotopic liver transplantation in 90 cases, partial living liver transplantation in 2 cases. Biliary reconstruction methods were end-to-end biliary anastomosis. Routine examination after liver transplantation and color Doppler ultrasound results were retrospectively an
6、alyzed. The inspection focused on whether common bile duct and intrahepatic bile duct had biliary leakage, biliary stenosis, biliary sludge or biliary calculus. Some patients underwent puncture and drainage under ultrasonographic guidance.RESULTS AND CONCLUSION: In all the 92 patients, 14 cases were
7、 diagnosed ultrasonically as biliary complications, including 5 cases of biliary leakage, 4 cases of biliary stenosis (2 cases of stomal stenosis and 2 cases of non-stomal stenosis), 4 cases of biliary sludge, and 1 case of biliary calculus. This study demonstrated that ultrasound characteristics co
8、uld be easily recognized in liver transplantation patients with biliary complications. Ultrasound has very important clinical value in diagnosis of the biliary complications after liver transplantation.中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程全文链接：Key words： liver transplantation; ultrasonography; biliary tract; gallstones; postoperative complications;中图分类号: R318 作者简介: 薄华颖，女， 1978 年生，辽宁省大连市人，2008 年大连医科大学影像医学与核医学专业毕业，硕士，主治医师，主要从事超声诊断学临床应用工作。
