Do biliary endoprostheses decrease biliary complications after liver transplantation?
OBJECTIVE
Most technical complications after orthotopic liver transplantation (OLT) are related to the biliary tree. This report reviews the role of routine intraoperative placement of stents to reduce biliary complications.


METHODS
We retrospectively analyzed 396 consecutive OLTs. We reviewed rates of biliary complications after hepaticojejunostomy (HJA) as well as following choledochocholedochostomy (CCA) groups: "experimental" group (routine intraoperative biliary stenting, last 10 months), "recent" control group (nonstented, previous 10 months), "historical" control group (prior to that period of time).


RESULTS
All groups were matched for donor/recipient characteristics and for graft cold/warm ischemia time. The overall prevalence of biliary complications was 30.7% after CCA versus 35% after HJA. In the experimental group 21 patients had a 4.8% biliary complication rate compared to the recent control and historical groups, where biliary complication rates were 30% and 32.6%, respectively (P <.05).


CONCLUSIONS
The intraoperative use of biliary stents is feasible and appears to decrease the rate of biliary complications. These results support the need for a prospective randomized trial.
Barkun
J S
JS
Department of General Surgery, Section of Transplantation and Hepatobiliary Surgery, Royal Victoria Hospital, McGill University Health Center, Montreal, Quebec, Canada. jeffrey.barkun@muhc.mcgill.ca
Tzimas
G N
GN
Cantarovich
M
M
Metrakos
P P
PP
Deschênes
M
M
Alpert
E
E
Paraskevas
S
S
Tchervenkov
J I
JI
D002768:Choledochostomy; D005500:Follow-Up Studies; D005704:Gallbladder / Q000601:surgery*; D005705:Gallbladder Diseases / Q000517:prevention & control*; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008099:Liver / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D013997:Time Factors