Abstract:

Objective To evaluate the safety and efficacy of a transhepatic dilation protocol involving theuse of a combined cutting and conventional balloon protocol in the management of anastomotic biliary strictures in adult liver transplant recipients. Methods From October 2014 to October 2015，10 adult transplant recipientsundergoing transhepatic cutting balloon dilation and conventional balloon for anastomotic biliary strictures or occlusion in Tianjin First Center Hospital were dissected retrospectively. 10 patients'（8 male and 2 female）ages wereranging from 34 to 64 years old，mean age was 50.8±9.89 years old . The clinical features，imaging examinations，complications of interventional treatment and prognosis were reviewed. Results The technical success rates andclinical success rates of dilation regimens for stenoses or occlusion were 100% and 90%，respectively.1 patients whose anastomotic biliary strictures had not improved retented drainage tube for 12 monthes. The others retented drainagetube for 3 - 6 monthes（4.33±1.22 monthes）. The follow-up was 5-16 months post-operation. In addition，no major traumatic complications（ie，pneumothorax，infection and hemobilia requiring blood transfusions）were encountered，Blood stains were found over the cutting balloon in 4 patients. Conclusion The use of cutting balloons andonventional balloons is safe and efficacy and can increase the technical success rate for anastomotic biliary strictures in adult liver transplant recipients.

摘要：

目的 探讨经切割球囊联合普通球囊扩张治疗成人肝移植术后胆管吻合口狭窄的安全性和有效性。方法 2014 年 10 月— 2015 年 10 月，于天津市第一中心医院应用切割球囊联合普通球囊扩张肝移植术后单纯胆管吻合口狭窄 / 闭塞患者 10 例，年龄为 34 ～ 64 岁，平均为（50.8±9.89）岁 ；其中男性 8 例，女性 2 例。观察患者的临床资料、影像随访资料、介入治疗的并发症、患者预后等情况。结果 切割球囊结合普通球囊扩张胆管吻合口狭窄的技术成功率为 100%。临床成功率为 90%（9/10），其中 1 例带管 12 个月的患者复查胆管吻合口仍狭窄，继续带管支撑引流。9 例成功拔管患者带管时间为 3 ～ 6 个月，平均为（4.33±1.22）个月。10 例患者切割球囊结合普通球囊扩张术后随访时间为 5 ～ 16 个月，术中有 4 例球囊表面带有血迹，术后随访过程中 1 例患者出现引流导管移位，未出现大出血、气胸、感染等严重并发症。结论 肝移植术后胆管狭窄患者经切割球囊联合普通球囊扩张是安全有效的，可以提高技术成功率。