ercp在伴有胆道并发症的活体肝移植受者细菌性胆管炎治疗中的作用:一项单中心研究

Sanaa M. Kamal, A. Wahed, S. Abdelhakam, H. Dabbous, Noha Alaa Eldin Fahim, D. Ghoraba
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引用次数: 0

摘要

肝移植尤其是活体供肝移植术后,胆道并发症仍较为常见。细菌性胆管炎是一种潜在的危及生命的并发症。治疗是基于抗菌药物治疗和手术引流。胆汁培养可以在确定病原体和优化抗生素治疗中发挥作用。本研究评估了LDLT受者中细菌性胆管炎的发生率,并评估了内镜逆行胆管造影术(ERCP)在管理潜在胆道感染中的作用。这项研究于2019年2月至2022年4月在艾因沙姆斯器官移植中心进行。所选的39例LDLT受者除胆道并发症外,还发生了移植后胆管炎。所有患者均行肝功能检查、影像学检查、ERCP检查。结果显示胆道并发症发生率为38.2%。影像学和ERCP检查结果吻合吻合口狭窄的诊断。12例患者ERCP检出结石,而磁共振胆管造影仅检出1例。ERCP前后炎症标志物(crp -降钙素原)、肝酶和总胆红素均有显著改善。
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ROLE OF ERCP IN MANAGEMENT OF BACTERIAL CHOLANGITIS IN LIVING-DONOR LIVER TRANSPLANT RECIPIENTS WITH BILIARY COMPLICATIONS: A SINGLE CENTER STUDY
Biliary complications are still frequent after liver transplantation especially living donor liver transplantation (LDLT). Bacterial cholangitis is a potentially life-threatening complication. Management is based on antimicrobial therapy and surgical drainage. Bile cultures can play a role in determining the causative agent and optimizing antibiotic therapy. This study assessed the incidence of bacterial cholangitis among recipients of LDLT and evaluated the role of endoscopic retrograde cholangiopancreatography (ERCP) in management of potential biliary infection. This study was conducted at Ain Shams Organ Transplantation Center between February 2019 and April 2022. The selected 39 LDLT recipients developed post-transplant cholangitis on top of biliary complications. Liver function tests, imaging, ERCP were performed in all patients. The results showed that incidence of biliary complications were 38.2%. Imaging and ERCP findings were consistent regarding the anastomotic stricture diagnosis. Stones were detected by ERCP in 12 patients when magnetic resonance cholangiopancreatography detected them in only one patient. Significant improvement as regard inflammatory markers (CRP-Procalcitonin) ,liver enzymes and Total bilirubin before and after ERCP.
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