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首页> 外文期刊>Gut and Liver >Safety and Efficacy of Endoscopic Retrograde Cholangiopancreatography in Patients with Post-Liver Transplant Biliary Complications: Results of a Cohort Study with Long-Term Follow-Up
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Safety and Efficacy of Endoscopic Retrograde Cholangiopancreatography in Patients with Post-Liver Transplant Biliary Complications: Results of a Cohort Study with Long-Term Follow-Up

机译：内镜逆行胰胆管造影术在肝移植后胆道并发症患者中的安全性和有效性：长期随访的队列研究结果

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Background/AimsEndoscopic retrograde cholangiopancreatography (ERCP) is the standard approach for the management of biliary complications in liver transplant patients; however, its safety and efficacy have not been established in this setting. This study was performed to evaluate the safety and long-term efficacy of ERCP in transplant patients.MethodsThe case reports of 1,500 liver transplant patients were reviewed. Orthotopic liver transplantation (OLT) patients were matched 1:2 with non-OLT patients and followed-up for long-term outcome (median, 7.4 years).ResultsOf the 1,500 liver transplant patients, 94 (6.3%) underwent 150 ERCPs after OLT. Anastomotic strictures were present in 45 patients, biliary stones in 24, biliary leaks in 7, papillary stenosis in 2, and primary sclerosing cholangitis in 1. An ERCP success rate of 90.7% was achieved; biliary stenting led to resolution of the bile leak in 7/7 (100%) patients, and biliary stones were removed in 21/24 (87.5%) patients. In addition, 34 of 45 patients with anastomotic stricture underwent endoscopic dilation. We obtained complete resolution in 22/34 (64.7%) patients. OLT patients did not show a higher probability of complications (odds ratio [OR], 1.04), of pancreatitis (OR, 0.80) or of bleeding (OR, 1.34).ConclusionsERCP is safe and effective for the treatment of post-OLT biliary complications, has a low rate of pancreatitis and results in a durable effect.
机译：背景/目的内镜逆行胰胆管造影术（ERCP）是治疗肝移植患者胆道并发症的标准方法。但是，在这种情况下尚未确定其安全性和有效性。本研究旨在评估ERCP在移植患者中的安全性和长期疗效。方法回顾了1500例肝移植患者的病例报告。将原位肝移植（OLT）患者与非OLT患者进行1：2配对，并随访长期结果（中位7.4年）。结果1,500例肝移植患者中，有94例（6.3％）接受OLT后的ERCP接受了150次。吻合口狭窄45例，胆结石24例，胆漏7例，乳头狭窄2例，原发性硬化性胆管炎1例，ERCP成功率为90.7％;胆道支架置入术可解决7/7（100％）患者的胆漏，而21/24（87.5％）患者的胆道结石被清除。此外，在45例吻合口狭窄患者中，有34例接受了内镜下扩张术。我们在22/34（64.7％）患者中获得了完全解决。 OLT患者的并发症（奇数比[OR]为1.04），胰腺炎（OR为0.80）或出血（OR为1.34）的并发症发生率较高。结论ERCP是治疗OLT后胆道并发症的安全有效方法，具有低的胰腺炎发生率，并具有持久的作用。

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