title: Assessment of early biliary complications after orthotopic liver transplantation and their relationship to the technique of biliary reconstruction.
abstract: BACKGROUND
  Biliary complications are known as the weak point of liver transplantation. Their occurrence can be related to the practice of drainage of the biliary anastomosis, the routine use of which was abandoned in June 2004. The aim of the study was to assess the incidence and type of biliary complications following orthotopic liver transplantation in relation to the technique of biliary anastomosis.
  
  
  METHODS
  We compared the results of two groups of adult liver transplant recipients: group I, recent 50 transplantations with biliary drainage (25 women: 25 men of age range: 17 to 63 years), and group II, first 50 transplantations without drainage (19 women and 31 men of age range, 20 to 65 years). We examined the problem of biliary complications and their influence on the further management of the patients. In both groups the main indications for transplantation were various types of cirrhosis as well as cholestatic diseases. In the majority of cases (n = 86) an end-to-end common bile duct anastomosis was performed and in 14 cases, hepaticojejunal anastomosis.
  
  
  RESULTS
  In group I, biliary complications requiring surgical or endoscopic intervention occurred in 10 (20%) recipients. In one case, biliary complications resulted in the need for retransplantation. In group II, biliary complications occurred in only four (8%) patients, none of which caused organ loss.
  
  
  CONCLUSIONS
  Cessation of biliary anastomosis drainage has reduced the occurrence of early biliary complications following orthotopic liver transplantation.
authors.affiliation: Department of General, Transplant and Liver Surgery, Warsaw Medical University, ul. Banacha 1a, 02-097 Warsaw, Poland. alsharabi@o2.pl
authors.forename: A
authors.initials: A
authors.lastname: Alsharabi
authors.forename: K
authors.initials: K
authors.lastname: Zieniewicz
authors.forename: W
authors.initials: W
authors.lastname: Patkowski
authors.forename: P
authors.initials: P
authors.lastname: Nyckowski
authors.forename: T
authors.initials: T
authors.lastname: Wroblewski
authors.forename: I
authors.initials: I
authors.lastname: Grzelak
authors.forename: B
authors.initials: B
authors.lastname: Michałowicz
authors.forename: R
authors.initials: R
authors.lastname: Paluszkiewicz
authors.forename: P
authors.initials: P
authors.lastname: Hevelke
authors.forename: P
authors.initials: P
authors.lastname: Remiszewski
authors.forename: B
authors.initials: B
authors.lastname: Cieślak
authors.forename: O
authors.initials: O
authors.lastname: Kornasiewicz
authors.forename: K
authors.initials: K
authors.lastname: Korba
authors.forename: A
authors.initials: A
authors.lastname: Skwarek
authors.forename: M
authors.initials: M
authors.lastname: Kotulski
authors.forename: U
authors.initials: U
authors.lastname: Ołdakowska
authors.forename: J
authors.initials: J
authors.lastname: Sanko-Resmer
authors.forename: L
authors.initials: L
authors.lastname: Paczek
authors.forename: M
authors.initials: M
authors.lastname: Krawczyk
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D001659:Biliary Tract / Q000000981:diagnostic imaging*; D002758:Cholangiography; D005260:Female; D005704:Gallbladder / Q000601:surgery*; D005705:Gallbladder Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000209:etiology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*