探讨纤维胆道镜治疗肝移植术后胆道铸型综合征（BCS）的安全性和疗效。

回顾性分析2014年3月至2016年6月在青岛大学附属医院应用纤维胆道镜治疗的10例肝移植术后BCS患者临床资料。其中男8例，女2例；年龄46～66岁，中位年龄50岁。原发病包括原发性肝癌6例，胆汁性肝硬化1例，乙型病毒性肝炎后肝硬化2例，丙型病毒性肝炎后肝硬化1例。患者均签署知情同意书，符合医学伦理学规定。肝移植术后早期患者更换T管，术后晚期患者分次行T管瘘道扩张术，然后纤维胆道镜取出胆道铸型（BC）并放置支撑引流管。

移植术后早期的BCS患者行更换T管2例，术后晚期行T管瘘道扩张8例，10例患者均成功采用纤维胆道镜取出BC，8例患者术后肝功能恢复正常，拔除胆道支撑引流管；2例患者胆管内BC再次形成并反复胆道感染，行PTCD引流。

纤维胆道镜治疗肝移植术后BCS是安全、有效、可行的。

To investigate the safety and efficacy of fiber choledochoscope in the treatment of patients with biliary cast syndrome (BCS) after liver transplantation (LT).

Clinical data of 10 patients with BCS after LT treated with fiber choledochoscope in the Affiliated Hospital of Qingdao University between March 2014 and June 2016 were analyzed retrospectively. There were 8 males and 2 females, aged 46-66 years old and the median age was 50 years old. The primary diseases of the patients were primary liver cancer (n=6), biliary cirrhosis (n=1), hepatic cirrhosis after hepatitis B (n=2), and hepatic cirrhosis after hepatitis C (n=1). The informed consents of all patients were obtained and the local ethical committee approval was received. For patients with BCS in the early stage after LT, T tube was replaced. For patients in late stage after LT, T tube fistula dilatation was performed, then biliary cast (BC) was removed and the supporting drainage tube was placed.

2 cases received T tube replacement when in early stage after LT, 8 received T tube fistula dilatation when in late stage after LT. All 10 cases had BC removed successfully with fiber choledochoscope. Liver function of 8 cases returned to normal after surgery, and the biliary drainage tube was removed. 2 cases had BC again and recurrent biliary infection, and then received PTCD drainage.

Fiber choledochoscope is safe, effective and feasible for the treatment of BCS after LT.