中国内镜杂志2024，Vol.30Issue(3)：7-13,7.DOI:10.12235/E20230338
取石球囊在内镜逆行胰胆管造影术治疗肝移植术后胆管吻合口狭窄中的特殊应用
Special application of stone extractor balloon catheter in ERCP for anastomotic biliary stenosis after liver transplantation
王旋 1陈雪雯 1黄金鑫 1陈佳骏 1曲岩 1高浩 1龚彪 1张晞文 1李甫1
作者信息
- 1. 上海中医药大学附属曙光医院 肝胆胰外科,上海 201203
- 折叠
摘要
Abstract
Objective To discuss the application effect of using a stone extractor balloon catheter to assist in crossing the anastomotic stenosis in treatment of anastomotic biliary stenosis after liver transplantation using endoscopic retrograde cholangiopancreatography(ERCP).Methods Clinical data of 48 patients who developed anastomotic biliary stenosis after liver transplantation and underwent ERCP treatment were collected.Upon unsuccessful use of a dilation catheter to cross the stricture,attempts were made to cross the anastomotic biliary stenosis by using a stone extractor balloon catheter.The success rate of the procedure was recorded,intraoperative conditions were observed,treatment outcomes and complications were analyzed.Results The main presenting symptoms in the 48 patients on admission were abdominal discomfort(32 patients),fever(7 patients),pruritus(4 patients),jaundice(3 patients),and no obvious symptoms(2 patients).Preoperative magnetic resonance cholangiopancreatography(MRCP)examination revealed isolated stricture of the anastomotic site in 35 cases,and stricture associated with stones in 13 cases.Using the stone extractor balloon catheter as a guide,guidewire crossing of the anastomotic stenosis was successful in 26 cases,resulting in a success rate of 54.17%(26/48).Through statistical analysis of the successful group and the failed group,there was a significant difference in whether the distal biliary dilatation between the two groups,and the difference was statistically significant(χ2 = 8.39,P = 0.004).In the 26 successfully treated cases,alanine transaminase(ALT),aspartate transaminase(AST),γ-glutamyl transpeptidase(γ-GT),alkaline phosphatase(ALP),and total bilirubin(TBiL)levels decreased significantly 48 hours after the procedure(P<0.05),and no serious complications occurred.Conclusion The use of a stone extractor balloon catheter significantly increases the success rate of crossing anastomotic stenosis in the treatment of anastomotic biliary stenosis after liver transplantation,especially in cases with distal dilatation of the common bile duct.This approach is safe and worth promoting.关键词
取石球囊/胆管吻合口狭窄/肝移植/内镜逆行胰胆管造影术(ERCP)/胆总管扩张Key words
stone extractor balloon catheter/anastomotic biliary stenosis/liver transplantation/endoscopic retrograde cholangiopancreatography(ERCP)/choledochectasia分类
医药卫生引用本文复制引用
王旋,陈雪雯,黄金鑫,陈佳骏,曲岩,高浩,龚彪,张晞文,李甫..取石球囊在内镜逆行胰胆管造影术治疗肝移植术后胆管吻合口狭窄中的特殊应用[J].中国内镜杂志,2024,30(3):7-13,7.
