Biliary Complications after Liver Transplantation

Publisher： Karger

E-ISSN： 2297-475x|22|2|73-78

ISSN： 2297-4725

Source： Visceral Medicine (formerly: Viszeralmedizin), Vol.22, Iss.2, 2006-06, pp. : 73-78

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Abstract

Background: The purpose of this study was to report themorbidity and mortality of patients who undergo liver transplantationwith or without T-tube implantation after choledochocholedochostomyas well as to discuss managementof bile duct complications. Patients and Methods: From August2001 to November 2005, a retrospective review of 94orthotopic liver transplantations was conducted. 43 patientsunderwent choledochocholedochostomy with T-tube implantation(group A); 45 patients underwent choledochocholedochostomywithout T-tube implantation (group B).Three patients who underwent living donor liver transplantationand 3 choledochojejunostomy patients were excluded.Results: Between the two groups, there were no significantdifferences in clinical characteristics, including sex,age, indication of liver transplantation (hepatitis B virus, hepatitisC virus, alcoholic liver cirrhosis, or hepatocellular carcinoma),Child-Pugh classification, preoperative laboratorydata, and operative, macroscopic and microscopic findings.Additionally, there were no significant differences in bileduct complications and overall survival rate. Of these 88 patientswith orthotopic liver transplantation, 11 (12.5%) developedbiliary complications (10 male, 1 female). Seven patientshad anastomostic stricture and underwent endoscopicretrograde cholangiopancreatography (ERCP) with stent implantation.In 5 of these patients ERCP and stent implantationfailed, and surgery was done with successful results.Conclusions: Whether or not stent implantation is done duringcholedochocholedochostomy after OLT has no impacton the frequency of biliary complications or survival time.The biliary complications after liver transplantation can bemanaged by ERCP with stent implantation. If ERCP fails, surgicalintervention should be considered immediately.