目的:探讨原位肝移植术后非吻合口胆管狭窄(NABS)的预防和治疗措施。方法:对2004年1月至2006年12月中山大学附属第一医院收治的516例同种原位肝移植病人的临床资料进行回顾性分析。总结肝移植术后发生NABS的情况。结果:共发生NABS 18例（3.5%）,其中肝门部胆管狭窄9例,肝内胆管多发狭窄6例,肝内外胆管多发狭窄3例。18例病人采用给予反复的介入、内镜治疗、外科重建胆道及再次肝移植治疗。该组近期临床治愈率为55.6%(10/18)，与NABS相关的再次肝移植率为38.9%(7/18)，与NABS相关病死率为22.2%(4/18)。结论:肝移植术后发生NABS临床处理棘手，应注重预防。NABS的治疗主要包括介入治疗和手术治疗，其中胆管介入治疗在NABS的临床处理中仍占重要地位，对于介入治疗、外科手术重建胆道等措施均无法控制其进行性发展的重度NABS病人，应把握好时机行再次肝移植。

Objective:To investigate the prevention and management of nonanastomotic biliary stricture (NABS) after orthotopic liver transplantation. Methods:The clinical data of 516 patients underwent orthotopic liver transplantation from January 2004 to December 2006 at the First Affiliated Hospital of Sun Yatsen University were analyzed retrospectively.The incidence and course of NABS after liver transplantation were summarized. Results:NABS occurred in 18 patients (3.5%).Among them,9 patients had biliary strictures at the site of hepatic bile duct bifurcation,and 6 patients had intrahepatic biliary strictures,and 3 patients had multiple extrahepatic and intrahepatic biliary strictures.Eighteen patients with NABS were managed with interventional therapy,endoscopic treatment,RouxenY anastomosis or retransplantation.The shortterm curative rate was 55.6% (10/18).The incidence of NABSrelated retransplantation was 38.9% (7/18),and the NABSrelated mortality was 22.2%(4/18). Conclusion:It is very complicated to manage NABS after liver transplantation.Therefore more attention should be paid to its prevention.The management of NABS mainly includes interventional therapy and surgery,among which interventional therapy is a important treatment.To the patients who failed interventional therapy and surgery, retransplantaiton is indicated.