생체간이식 후 발생한 담도협착 환자에서 경피적 풍선확장술과 도관유지술|RISS 상세보기

다국어 초록 (Multilingual Abstract)

Purpose: The aim of this study was to evaluate the therapeutic efficacy of the percutaneous balloon dilatation and catheter maintenance (BDCM) method for postoperative biliary strictures following living donor liver transplantation (LDLT).
Materials and Methods: Eighteen patients (14 duct-to-duct anastomosis and 4 hepaticojejunostomy) with post-LDLT biliary stricture were treated by the percutaneous BDCM method. A good response was defined as residual stricture over 3.5 mm after repetitive BDCM and refractory response as residual stricture below 3.5 mm. If they demonstrated good results on follow-up studies after catheter withdrawal, all the patients quit the therapy. We evaluated the technical and clinical success rates, major complication rate, mean total procedure time and mean follow-up duration.
Results: The percutaneous BDCM method was technically successful without major complication. Nine patients improved biliary stricture (good response, mean 5.5 mm), and the other 9 patients showed residual stricture with the diameter below 3.5 mm (refractory response, mean 2.5 mm). However, all the patients were improved clinically without significant complication. The total procedure time was 1-15 months (mean 7.3 months) and follow-up duration was 6-54 months (mean 24 months).
Conclusion: The percutaneous BDCM method for post-LDLT biliary strictures was an effective therapy even in the patients showing a refractory response. It seemed that total procedure time could be reduced if the response was determined earlier.

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국문 초록 (Abstract)

목적: 생체간이식 후 발생한 담도협착 환자에서 경피적 풍선도관술(풍선확장술과 도관유지술)의 치료적 효능에 대해 알아보고자 하였다.
대상과 방법: 생체간이식 후 발생한 담도협착으로 경피적 풍선도관술을 시행받은 18명의 환자를 대상으로 하였다(담도-담도 문합술 14명, 간-공장 문합술 4명). 반복적인 치료 후 잔류협착이 3.5 mm 이상으로 유지되는 경우를 호전군이라 하였고, 잔류협착이 3.5 mm 이하로 유지되는 경우 불응군으로 하였다. 호전군과 불응군 모두 도관을 협착 부위에서 제거한 후 추적 검사에서 이상이 없을 때 시술을 종료하였다. 기술적 및 임상적 성공률, 주요합병증, 총 시술시간을 알아보았다.
결과: 풍선도관술은 모든 환자에서 기술적으로 성공하였고 주요 합병증은 없었다. 9명의 환자에서 협착은 호전을 보였고(호전군, 평균 5.5 mm), 나머지 9명의 환자에서 잔류협착이 3.5 mm 미만으로 유지되었다(불응군, 평균 2.5 mm). 그러나 모든 환자는 시술 종료 후 의미 있는 합병증 없이 임상적으로 호전되었다. 총 시술기간은 1~15개월(평균 7.3개월)이었고, 추적 관찰 기간은 6~54개월(평균 24개월)이었다.
결론: 경피적 풍선도관술은 생체간이식 후 발생한 담도협착 환자에서 효과적인 치료법이다. 불응군에서도 경피적 치료는 효과가 있었으므로 시술에 대한 반응을 빨리 결정하면 총 시술시간을 줄일 수 있을 것이라 사료된다.

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목적: 생체간이식 후 발생한 담도협착 환자에서 경피적 풍선도관술(풍선확장술과 도관유지술)의 치료적 효능에 대해 알아보고자 하였다. 대상과 방법: 생체간이식 후 발생한 담도협착으로 ...

참고문헌 (Reference)

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