08 June 2001
Biliary Complications in Liver TransplantationPetr Nemec, Jiri Ondrasek, Pavel Studenlk, Jan Hokl, Jan Cerny
Ann Transplant 2001; 6(2): 24-28 :: ID: 498321
Objectives: Biliarycomplications (BC) continue to be a major cause of morbidity among liver transplant recipients. The aim of this study was to analyse the incidence, risk factors and management of biliary tract complications at the Centre for Cardiovascular Surgery and Transplantations in Bmo. Methods: Between January 1992 and December 2000, 118 orthotopic LT were performed in 113 patients. Reconstructions of biliary tract included four methods: end-to-end choledochocholedochostomy with a drain in the retained gallbladder in 15 cases, end-to-end or side-to-side choledochocholedochostomy with a T tube in 29 cases, end-to-end choledochocholedochostomy without a T tube in 67 cases and choledochojejunostomy over the drain in 7 cases. Biliary complications were divided into three groups: stenosis, leaks and cholangitis. Results: Biliarycomplications occurred after 33 LT (27. 9OA»,affecting 28.3% of the recipients. They occurred most frequently when CCw T or CJ types of reconstruction were used (44.8 % and 57.1%, respectively) and least frequently in the CCw/oT group of patients (16.4 %). The most common type of biliary complication was stenosis which occurred in 20 patients (in 12 at the anastomotic site, in 5 it was caused by external compression and 3 had nonanastomotic strictures); biliary leaks were in 13 patients and cholangitis in 10 patients. Twenty three biliary complications occurred in the early postoperative period and 12 during the follow-up. Endoscopic treatment was used as primary therapy in 17 patients, primary surgical intervention was used in 12 patients and five patients were treated conservatively. Five patients died due to biliary complications (mortality, 15.1%). Conclusions: It can be concluded that BC is a common cause of morbidity after LT. In the last few years, its frequency has remained constant. Technical failure or local ischemia are major causes. Biliary leaks predominate in the early posttransplant period. Since end-to-end choledochocholedochostomy without a T tube is associated with the lowest incidence of BC, it is considered to be the method of choice. BC can usually be managed endoscopically, although early leaks frequently require reoperation. Aggressive and early management of BC can reduce mortality in patients after LT.
Keywords: Liver Transplantation, biliar ycomplication, use of T tube
17 May 2023 : Original articleResults of Liver Retransplantation After Rescue Hepatectomy: A Single-Center Study
Ann Transplant In Press; DOI: 10.12659/AOT.939557
10 May 2023 : Original articleIncidence of Thromboembolic Complications Following Kidney Transplantation with Short and Extended Aspirin ...
Ann Transplant In Press; DOI: 10.12659/AOT.939143
Most Viewed Current Articles
24 Aug 2021 : Review articleNormothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review articleRecurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588
15 Mar 2022 : Case reportCombined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...
Ann Transplant 2022; 27:e935860