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Ultrasound Diagnosis and Interventional Treatment of Biliary Complication of Orthotopic Transplant Liver <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
刘利民 黄备建 张晖 张韵华
复旦大学附属中山医院超声诊断科，上海200032
Liu limin, Huang Beijian, Zhang Hui,et al (Department of Diagnostic Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032,China)
Abstract
Objective：To investigate the sonograghic features and the interventional treatment of the biliary complication of orthotopic transplant liver.
Methods：One hundred and thirty cases of orthotopic liver transplant patients were retrospectly analyzed.
Results：Biliary tract abnormalities were found ay US in forty-four patients. There were thirty-seven biliary dilations, six bile leaks, four biliary stones, seven biliary sludges. Percutaneous transhepatic bile drainage were performed in two cases and bile leak drainage in five cases.
Conclusion：Ultrasound is a sensitive method in diagnosis biliary complications of transplant liver. Ultrasound examinations should be performed periodically. Interventional ultrasound is an effect method for perihepatic bile leakage treatment.
Key Words：Transplant liver; Ultrasound; Biliary complication
原位肝移植是治疗终末期肝脏病变的良好方法。肝移植术后存在一定并发症，胆管并发症是其中之一，早期诊断及及时处理对提高移植肝生存时间有重要意义。本文对我院130例肝移植中有异常超声表现的44例资料进行分析总结，报道如下。
资料和方法
1999年10月～2004年5月130例肝移植患者，其中44例超声提示胆管异常。44例患者中，男性39例，女性5例，年龄4～63岁，平均43岁。超声检查次数1－19次，平均7.0次。随访时间，1－36月，平均7.3月。
超声检查使用Esaote DU6、Acuson 128XP、HP 8500GP超声仪，探头频率3.5MHz。超声检查在超声检查室或床旁进行。移植肝检查包括移植肝血管内径，有无狭窄，栓塞等，肝动脉测量收缩期峰值流速，阻力指数，门静脉、肝静脉及下腔静脉测量最高流速。观察肝脏内部回声，有无增粗及局限性回声改变，有无占位及积液，了解胆管系统内径，形态、胆道回声及管腔内回声，了解有无胆道扩张、狭窄及结石等。观察腹腔有无积液、腹水。介入性超声包括积液引流及胆管引流。穿刺针为18G穿刺针，8F引流管，以普通3.5MHz探头引导穿刺。 | 
