肝移植后胆道并发症的超声诊断价值

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。

Diagnostic value of ultrasound for biliary complications after liver transplantation

BACKGROUND：Biliary complications after liver transplantation can cause liver graft dysfunction. Ultrasound examination is one 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, aged 21-67 years;al ogenic 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 analyzed. 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 al the 92 patients, 14 cases were diagnosed ultrasonical y 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 could 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.