Management of biliary complications following orthotopic liver transplantation
- VernacularTitle:原位肝移植术后胆道并发症治疗经验
- Author:
Shusen ZHENG
;
Xiao XU
;
Tingbo LIANG
;
Weiliang XIA
;
Weilin WANG
;
Jian WU
;
Haiyong CHEN
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Biliary complication;
Treatment
- From:
Chinese Journal of General Surgery
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the management of biliary complications (BC) following orthotopic liver transplantation (OLT). Methods From Feb 1999 to Feb 2004, 236 cases underwent OLT with end-to-end choledocho-choledochostomy. Biliary anastomosis was performed by intermittent suture with T tube placement in 96 cases, without T tube in 39 cases, by continuous suture in posterior wall and intermittent suture in anterior wall and without T tube in 101 cases. Results Thirty-two (13.3%) patients developed BC, with incidences in group 1, 2 and 3 of 17.7%, 15.4% and 7.9%, respectively. The incidence of hepatic hilar and/or intrahepatic bile duct strictures was 8.3%, 2.6% and 1.0%, respectively. BC incidence in group 3 significantly decreased. Twenty patients with biliary stricture underwent endoscopic and/or radiological interventions, and stricture resolution was achieved in 90% of patients with anastomotic strictures and 60% of patients with hepatic hilar and/or intrahepatic strictures. Conclusions Modified biliary tract reconstruction technique contributes to the decrease of BC. Endoscopic and/or radiological interventions should be used for non-ischemic anastomotic biliary strictures or simple hepatic hilar strictures.
