Practical Journal of Organ Transplantation(Electronic Version) ›› 2013, Vol. 1 ›› Issue (2): 103-106.

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Percutaneous transhepatic angioplasty for the treatment of post-transplantation portal vein stenosis

WANG Hao，CHEN Guang，GAO Hai-jun，WEN Lian-fang，WANG Peng-hui，YANG Yi-xin，ZHU Zhi-jun，ZHENGHong，DENG Yong-lin，PAN Cheng.   

  1. Department of Radiology，First Center Hospital，Tianjin 300192，China

  • Online:2013-03-20 Published:2021-04-20

经皮经肝血管成形术治疗肝移植术后门静脉狭窄

王浩，陈光，高海军，温连芳，王鹏辉，杨颐馨，朱志军，郑虹，邓永林，潘澄
  

  1. 天津市第一中心医院放射科，天津 300192
  • 基金资助:
    天津市科委重点项目（12zczdsy02600）

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Abstract:

Objective To evaluate the therapeutic results of percutaneous transhepatic stent angioplasty for portal vein stenosis following liver transplant. Methods From 2005 to 2012，37 patients developed portal vein stenosis following liver transplant. Percutaneous transhepatic angioplasty of the portal vein was performed in allpatients. The clinical data，imaging follow-up data，complications of interventional treatment and prognosis weresummarized. Results In all patients，the percutaneous transhepatic angioplasty were successful. It was placed with7 pieces of self-expanding metallic stents，29 pieces of balloon-expandable coronary stent，
and 1 piece of membranous stent. 1 case of pediatric liver transplant patients was only used balloon angioplasty. 1 case with abdominal hemorrhageof early postoperative（2.70%），diagnosis of hepatic artery hemorrhage by hepatic artery angiography and cured byinterventional embolization. The follow up period ranged from 3 months to 80 months. Portal venous patency was
maintained in 33 patients（1 patient died due to multi organ failure because of concomitant hepatic artery occlusion and ischemic bile duct injury after 3 months，1 patient accept the second liver transplantation because of the biliary tract complications，1 case was placed membranous tent again because of portal vein stent carcinoma bolt，and 1 case with stent restenosis）. Conclusion Percutaneous transhepatic stent angioplasty is an effective and safe method for treatment of portal vein stenosis following liver transplant.

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摘要：

目的 探讨经皮经肝血管成形术在肝移植术后门静脉狭窄治疗中的应用价值。方法 回顾性分析 37 例肝移植术后发生门静脉狭窄患者的资料，所有患者均采用经皮经肝血管成形术治疗，对患者临床资料、影像随访资料、介入治疗的并发症和预后等情况进行总结。结果 介入治疗的手术成功率为 100%。共置入自膨式支架 7 枚、球囊扩张式支架 29 枚、覆膜支架 1 枚，对 1 例小儿肝移植患者单纯采用球囊扩张成形术治疗。与门静脉成形术治疗相关的严重并发症肝内血肿 1 例，发生率为 2.70%，经肝动脉造影证实为肝动脉出血，予以介入栓塞治疗后出血停止。随访 3～80 个月，1 例因同时合并肝动脉闭塞、缺血性胆道损伤于术后 3 个月死于多器官功能衰竭 ；1 例因胆道并发症接受二次肝移植 ；1 例因门静脉主干内癌栓形成再次置入覆膜支架 ；1 例发生支架内再狭窄 ；其余 33 例患者影像随访显示门静脉通畅。结论 肝移植术后门静脉狭窄的血管成形术治疗是一种安全、有效的治疗方法。

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Practical Journal of Organ Transplantation(Electronic Version)
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