| Autor: |
Hervé Rousseau, Olivier Meyrignac, Noé Roussel, F Z Mokrane, Paul Revel, Philippe Otal, Charline Zadro |
| Rok vydání: |
2020 |
| Předmět: |
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| DOI: |
10.1016/b978-0-323-61204-3.00038-5 |
| Popis: |
Liver transplantation is now accepted as the gold standard treatment of many end-stage liver diseases. The piggyback technique is the most used orthotopic liver transplantation. The improving survival rates are based on progress in medical care and surgical and endovascular techniques. Hepatic artery complications after liver transplantation are uncommon but represent an important cause of morbidity, mortality, and retransplantation. Hepatic artery angioplasty can be used for treatment of solitary focal stenosis. The portal complication rate is very low; percutaneous angioplasty is effective in the treatment of portal vein stenosis but has to be reserved to patients with symptoms of portal hypertension. Endovascular treatment of hepatic artery thrombosis has emerged as an alternative procedure, even in the early phase after transplantation. A stenosis may develop at the suprahepatic or infrahepatic anastomoses in the standard orthotopic technique or involve the hepatic vein orifices or cavocaval anastomosis in the piggyback technique. For the endovascular treatment of hepatic venous stenoses, multiple angioplasties may be necessary to obtain a good result in the long term. Bile duct complications are an important cause of postsurgical morbidity and graft survival. The percutaneous treatment of anastomotic biliary strictures consists of an initial balloon biloplasty followed by long-term drainage with large-bore drains; for biliary leaks, a large internal drain catheter is placed within the bile ducts to have the upper series of side holes in the intrahepatic bile ducts above the leak and the lower holes in the duodenum. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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