Актуальность

vmireaviz

Вестник медицинского института «РЕАВИЗ». Реабилитация, Врач и Здоровье

Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)

2226-762X2782-1579

РЕАВИЗ

10.20340/vmi-rvz.2023.6.TX.1

vmireaviz-884

Research Article

Донорство и трансплантация органов и тканей

Organ and tissue donation and transplantation

Современные подходы к диагностике и лечению билиарных осложнений после трансплантации печени. Обзор литературы

Modern approaches to the diagnosis and treatment of biliary complications after liver transplantation (literature review)

https://orcid.org/0000-0002-5057-6628

Магомедов

К. М.

Magomedov

K. M.

Магомедов Кубай Магомедович - Врач-хирург, научный сотрудник центра трансплантации печени.

Большая Сухаревская пл., д. 3, Москва, 129090

Kubay M. Magomedov - Surgeon, researcher at the liver transplantation center.

3, Bolshaya Sukharevskaya Square, Moscow, 129090

https://orcid.org/0000-0002-6362-7914

Новрузбеков

М. С.

Novruzbekov

M. S.

Новрузбеков Мурад Сафтарович - Д-р мед. наук, профессор, научный руководитель центра трансплантации печени, НИИСП им. Н.В. Склифосовского; заведующий кафедрой трансплантологии и искусственных органов; профессор кафедры хирургических болезней, РНИИМУ им. Н.И. Пирогова.

Большая Сухаревская пл., д. 3, Москва, 129090; ул. Островитянова д. 1, Москва, 117997

Murad S. Novruzbekov - Dr. Sci. (Med.), Professor, Scientific Director of the Liver Transplantation Center, N.V. Sklifosovsky RIE M; Head of the Department of Transplantology and Artificial Organs; Professor of the Department of Surgical Diseases, N.I. Pirogov Russian NRMU.

3, Bolshaya Sukharevskaya Square, Moscow, 129090; 1, Ostrovityanova str., Moscow, 117997

https://orcid.org/0000-0001-8650-0855

Гуляев

В. А.

Gulyaev

V. A.

Гуляев Владимир Алексеевич - Д-р мед. наук, ведущий научный сотрудник центра трансплантации печени, врач-хирург.

Большая Сухаревская пл., д. 3, Москва, 129090

Vladimir A. Gulyaev - Dr. Sci. (Med.), leading researcher at the Liver Transplantation Center, surgeon.

3, Bolshaya Sukharevskaya Square, Moscow, 129090

https://orcid.org/0000-0003-2305-4055

Луцык

К. Н.

Lutsyk

K. N.

Луцык Константин Николаевич - Д-р мед. наук, врач-хирург, заведующий отделением трансплантации печени.

Большая Сухаревская пл., д. 3, Москва, 129090

Konstantin N. Lutsyk - Dr. Sci. (Med.), Surgeon, Head of the Liver Transplantation Department.

3, Bolshaya Sukharevskaya Square, Moscow, 129090

https://orcid.org/0000-0001-5723-4818

Казымов

Б. И.

Kazymov

B. I.

Казымов Бахтияр Исметович - Врач-хирург, научный сотрудник центра трансплантации печени, НИИСП им. Н.В. Склифосовского; ассистент кафедры хирургических болезней, ММУ «Реавиз».

Большая Сухаревская пл., д. 3, Москва, 129090; ул. Краснобогатырская, д. 2, стр. 2, Москва, 107564

Bakhtiyar I. Kazymov - Surgeon, researcher at the Liver Transplantation Center, N.V. Sklifosovsky RIEM; Assistant of the Department of Surgical Diseases, MMU "Reaviz".

3, Bolshaya Sukharevskaya Square, Moscow, 129090; 2, Krasnobogatyrskaya str., p. 2, Moscow, 107564

https://orcid.org/0000-0002-2264-7038

Алекберов

К. Ф.

Alekberov

K. F.

Алекберов Кямран Файгович - Врач-хирург, научный сотрудник центра трансплантации печени.

Большая Сухаревская пл., д. 3, Москва, 129090

Kyamran F. Alekberov - Surgeon, researcher at the Liver Transplantation Center.

3, Bolshaya Sukharevskaya Square, Moscow, 129090

https://orcid.org/0000-0001-6604-0927

Ахмедов

А. Р.

Akhmedov

A. R.

Ахмедов Амир Русланович - Врач-хирург, научный сотрудник центра трансплантации печени.

Большая Сухаревская пл., д. 3, Москва, 129090

Amir R. Akhmedov - Surgeon, researcher at the Liver transplantation Center.

3, Bolshaya Sukharevskaya Square, Moscow, 129090

https://orcid.org/0000-0002-0241-1298

Аносова

Е. Ю.

Anosova

Е. Yu.

Аносова Екатерина Юрьевна - Врач-клинический ординатор центра трансплантации печени.

Большая Сухаревская пл., д. 3, Москва, 129090

Ekaterina Yu. Anosova - Clinical resident of the liver transplantation Center.

3, Bolshaya Sukharevskaya Square, Moscow, 129090

anosova.kate@gmail.com

https://orcid.org/0000-0001-5889-8675

Яремин

Б. И.

Yaremin

B. I.

Яремин Борис Иванович - Канд. мед. наук, врач-хирург, научный сотрудник центра трансплантации печени, НИИСП им. Н.В. Склифосовского; доцент кафедры трансплантологии и искусственных органов, РНИМУ им. Н.И. Пирогова; заведующий кафедрой хирургических болезней, ММУ «Реавиз».

Большая Сухаревская пл., д. 3, Москва, 129090; ул. Островитянова д. 1, Москва, 117997; ул. Краснобогатырская, д. 2, стр. 2, Москва, 107564

Boris I. Yaremin - Cand. Sci. (Med.), Surgeon, Researcher at the Liver Transplantation Center, N.V. Sklifosovsky RIEMedicineov RNRMU; Head of the Department of Surgical Diseases, MMU "Reaviz".

3, Bolshaya Sukharevskaya Square, Moscow, 129090; 1, Ostrovityanova str., Moscow, 117997; 2, Krasnobogatyrskaya str., p. 2, Moscow, 107564

Научно-исследовательский институт скорой помощи им. Н.В. СклифосовскогоРоссияN.V. Sklifosovsky Research Institute of Emergency MedicineRussian Federation

Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского; Российский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияN.V. Sklifosovsky Research Institute of Emergency Medicine; N.I. Pirogov Russian National Research Medical UniversityRussian Federation

Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского; Московский медицинского университета «Реавиз»РоссияN.V. Sklifosovsky Research Institute of Emergency Medicine; Moscow Medical University "Reaviz"Russian Federation

Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского; Российский национальный исследовательский медицинский университет им. Н.И. Пирогова; Московский медицинского университета «Реавиз»РоссияN.V. Sklifosovsky Research Institute of Emergency Medicine; N.I. Pirogov Russian National Research Medical University; Moscow Medical University "Reaviz"Russian Federation

2023

15012024

136156162

2024

Магомедов К.М., Новрузбеков М.С., Гуляев В.А., Луцык К.Н., Казымов Б.И., Алекберов К.Ф., Ахмедов А.Р., Аносова Е.Ю., Яремин Б.И.

Magomedov K.M., Novruzbekov M.S., Gulyaev V.A., Lutsyk K.N., Kazymov B.I., Alekberov K.F., Akhmedov A.R., Anosova Е.Y., Yaremin B.I.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://vestnik.reaviz.ru/jour/article/view/884

Актуальность

Актуальность. Выбор билиарного анастомоза является основным фактором, определяющим риск развития билиарных осложнений после ортотопической трансплантации печени. Двумя наиболее распространёнными формами реконструкции желчевыводящих путей являются холедохохоледохостомия (анастомоз протока с протоком) и холедохоеюностомия (соединение желчного протока с частью тощей кишки). Выбор реконструкции желчевыводящих путей определяется множеством факторов, включая основную патологию печени, размер желчных протоков донора и реципиента, предшествующую трансплантацию или предыдущую операцию на желчевыводящих путях, а также предпочтения выполняющего операцию хирурга. Несмотря на верно подобранный способ реконструкции нечасто, но возникают осложнения, такие как стриктуры, литиаз, билома, подтекание желчи.

Цель

Цель: представить обзор литературы по способам диагностики и лечения билиарных осложнений после трансплантации печени.

Материалы и методы

Материалы и методы. Проведён анализ литературных источников на английском и русском языках с 2010 по 2023 год по данной теме в базах PubMed, MEDLINE, Google Scholar. В обзоре освещены клинические исследования, а также литературные обзоры по схожей тематике с акцентом на лечение и диагностику билиарных осложнений.

Заключение

Заключение. Проблема билиарных осложнений трансплантации печени остается актуальной и до конца нерешенной. Неинвазивные методы визуализации осложнений, возникающих после операций на желчевыводящих путях, имеют перспективы развития. Тактика перкутанных, эндоскопических и открытых вмешательств на билиарном дереве трансплантата требует дальнейшего совершенствования.

Relevance

Relevance. The choice of biliary anastomosis is the main factor determining the risk of developing biliary complications after orthotopic liver transplantation. The two most common forms of biliary tract reconstruction are choledocholedochostomy (duct-to-duct anastomosis) and choledochoeunostomy (connection of the bile duct to the jejunum). The choice of biliary tract reconstruction is determined by a variety of factors, including the underlying pathology of the liver, the size of the bile ducts of the donor and recipient, previous transplantation or previous biliary tract surgery, as well as the preferences of the surgeon performing the operation. Despite the correctly chosen method of reconstruction, complications such as strictures, lithiasis, biloma, and bile leakage occur infrequently.

Objective

Objective: to present a review of the literature on methods of diagnosis and treatment of biliary complications after liver transplantation.

Materials and methods

Materials and methods. The analysis of literary sources in English and Russian from 2010 to 2023 on this topic in the databases PubMed, MEDLINE, Google Scholar was carried out. The review highlights clinical studies, as well as literature reviews on similar topics with an emphasis on the treatment and diagnosis of biliary complications.

Conclusion

Conclusion. The problem of biliary complications of liver transplantation remains relevant and unresolved to the end. Noninvasive imaging techniques for complications arising after biliary tract surgery have prospects for development. The tactics of percutaneous, endoscopic and open interventions on the biliary graft tree require further improvement.

билиарные осложнениятрансплантация печениэндоскопическая ретроградная холангиопанкреатографиябилиарное дренирование

biliary complicationsliver transplantationendoscopic retrograde cholangiopancreatographybiliary drainage

Исследование проводилось без спонсорской поддержки

This research received no external funding

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The authors declare that there are no conflicts of interest present.