Assessment of early biliary complications after orthotopic liver transplantation and their relationship to the technique of biliary reconstruction.
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.
Alsharabi
A
A
Department of General, Transplant and Liver Surgery, Warsaw Medical University, ul. Banacha 1a, 02-097 Warsaw, Poland. alsharabi@o2.pl
Zieniewicz
K
K
Patkowski
W
W
Nyckowski
P
P
Wroblewski
T
T
Grzelak
I
I
Michałowicz
B
B
Paluszkiewicz
R
R
Hevelke
P
P
Remiszewski
P
P
Cieślak
B
B
Kornasiewicz
O
O
Korba
K
K
Skwarek
A
A
Kotulski
M
M
Ołdakowska
U
U
Sanko-Resmer
J
J
Paczek
L
L
Krawczyk
M
M
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*