Biliary complications in one hundred adult liver transplantations.
BACKGROUND
Biliary complications are a common problem in liver transplantation (LT).


METHODS
We reviewed 100 consecutive adult LTs, including 10 retransplantations. Ten patients who survived for less than 1 month or developed hepatic artery thrombosis were excluded. Biliobiliary anastomosis was performed with a T-tube (CCT) (n = 25) or without it (CC) (n = 59), or biliodigestive anastomosis (Rouxen-Y) (n = 6) was used.


RESULTS
Biliary complications (8 anastomotic strictures and 9 bile leakages) occurred in 15 LTs. Surgical treatment was needed for seven strictures and two leakages. Complications tended to be more frequent with CCT than with CC (24% versus 12%). Biliary complications were often accompanied by cytomegalovirus disease and bacterial infections. After a median follow-up time of 5.2 years, total patient survival was 71% for all 100 LTs and 81% for those with biliary complications.


CONCLUSIONS
Biliary complications are rather frequent after LTs; they are often preceded by infections but can be treated and do not cause excessive mortality. T-tubes are not to be recommended.
Koivusalo
A
A
Fourth Dept. of Surgery, Helsinki University Central Hospital, Finland.
Isoniemi
H
H
Salmela
K
K
Edgren
J
J
von Numers
H
H
Höckerstedt
K
K
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D001424:Bacterial Infections / Q000453:epidemiology; D001660:Biliary Tract Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D002779:Cholestasis / Q000453:epidemiology*; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D004322:Drainage / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007440:Intubation / Q000009:adverse effects* / Q000295:instrumentation; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000453:epidemiology*; D011897:Random Allocation; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors