T-tube drainage for biliary stenosis after living donor liver transplantation.
The optimal strategies for bile duct stenosis after living donor liver transplantation with duct-to-duct biliary reconstruction remain unclear. Patients who underwent liver transplantation with duct-to-duct bile duct reconstruction (n=182) and were complicated with biliary stenosis (n=34) were analyzed. Treatment of biliary stenosis was attempted using an endoscopic approach or transhepatic biliary drainage. When this failed, the T-tube drainage technique was indicated. T-tube placement was performed in 14 patients. Intraoperative ultrasonography was performed to identify the bile duct. The common bile duct was cut open, a Kelly clamp was inserted and the stenotic portion was dilated, and a T-tube was inserted. The patients were scheduled to have the tube removed 1 year after insertion. Complications following T-tube placement or T-tube removal were negligible. The present technique can be an effective therapeutic option when endoscopic treatment is unsuccessful.
Hashimoto
Masao
M
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Sugawara
Yasuhiko
Y
Tamura
Sumihito
S
Kishi
Yoji
Y
Matsui
Yuichi
Y
Kaneko
Junichi
J
Makuuchi
Masatoshi
M
D001652:Bile Ducts / Q000473:pathology* / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures; D003251:Constriction, Pathologic; D004322:Drainage; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods*; D019520:Living Donors; D008875:Middle Aged