Clinical trial on the cost-effectiveness of T-tube use in an established deceased donor liver transplantation program.
The aim of our study was to assess the advantages and disadvantages of T-tube use in liver transplantation, with also paying attention to the economic costs derived from its use. Patients were prospectively randomized to T tube or no T tube. One hundred and seven patients, 53 with T tube and 54 without T tube, were analyzed. Minimum follow-up was three months. Nine patients (8.4%) had bile leak: six in the T-tube group (11.3%) and three in the group without T tube (5.5%), p = ns. Four patients (3.5%) had anastomotic biliary stenosis: one in the T-tube group (1.8%) and three in the group without T tube, p = ns. Twenty of the 53 patients (37.7%) with T tube had T-tube-related complication. The number of diagnostic and therapeutic resources were higher in the T-tube group compared with non-T tube (81 and 17 vs. 18 and 10, respectively, p <0.05). The costs of therapeutic procedures required for the treatment of complications were 28 232 euro in the T-tube group vs. 16 088 euro in the no T-tube group, p <0.05. In conclusion, the systematic use of the T tube in biliary reconstruction in liver transplantation cannot be justified.
Amador
A
A
Liver Transplantation Unit, ICMDM, Hospital Clinic i Provincial, IDIBAPS, Barcelona, Spain.
Charco
R
R
Martí
J
J
Navasa
M
M
Rimola
A
A
Calatayud
D
D
Rodriguez-Laiz
G
G
Ferrer
J
J
Romero
J
J
Ginesta
C
C
Fondevila
C
C
Fuster
J
J
García-Valdecasas
J C
JC
D000328:Adult; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery*; D002102:Cadaver; D003362:Cost-Benefit Analysis; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics*; D011446:Prospective Studies; D013514:Surgical Procedures, Operative; D014019:Tissue Donors