Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

01 December 2005

Biliary Complications Following Adult Liver Transplantation with Routine Use of External Biliary Drainage

Maciej Wójcicki, Jerzy Lubikowski, Samir Zeair, Mariola Gasińska, Jacek Butkiewicz, Maria Czupryńska, Konrad Jarosz, Katarzyna Zasada - Cedro

Ann Transplant 2005; 10(3): 21-25 :: ID: 433651

Abstract

Objectives: Biliary complications are still common and often related to the use of biliary drains in liver transplant setting. We analyzed the incidence, treatment and outcome of biliary complications following adult orthotopic liver transplantation (OLTx) performed between February 2002 and October 2004.
Methods: Overall there were 46 OLTx performed in 44 patients. Two cases of primary graft-non-function (one re-graft) and 2 early postoperative deaths were excluded from the study resulting in 42 OLTx performed in 41 patients included in the final analysis. Biliary reconstruction was by duct-to-duct choledochocholedochostomy (DD, n=37) and Roux-en-Y hepaticojejunostomy (RYHJ, n=5) performed over an external Levin type biliary drain in all cases.
Results: The overall incidence of biliary complications was 28.6% (12/42). Bile leak was the commonest and occurred in 16.6% (7/42) of transplants, whereas biliary strictures were found in 3 (7.2%) patients. Eight (19%) patients required surgical treatment and one patient died due to a biliary complication (2.4% mortality rate). Majority (7/12) of complications were bile drain related and all of these occurred in patients with DD anastomosis.
Conclusion: Biliary complications continue to cause significant morbidity after OLTx but rarely result in mortality if early diagnosis and prompt therapy is applied. Majority of biliary complications following DD anastomosis have been related to the use of biliary drains. In view of this and endoscopic expertise available, duct to duct anastomosis without a biliary drain may reduce complication rates and improve outcome.

Keywords: Biliary Reconstruction, Bile Leak, Biliary Stricture, Roux-en-Y Hepaticojejunostomy, Choledochocholedochostomy

0 Comments

Most Viewed Current Articles

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

24 Aug 2021 : Review article  

Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives

DOI :10.12659/AOT.931664

Ann Transplant 2021; 26:e931664

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358