Pedicled greater omentum flap for preventing bile leak in liver transplantation patients with poor biliary tract conditions.
BACKGROUND
Bile leak remains a main complication in liver transplantation patients with poor biliary tract conditions, mainly caused by an insufficient blood supply or dysplasia of the biliary tract. Although Roux-en-Y modus operandi can be adopted, the risk of other complications of the biliary tract such as infection increases. Using pedicled greater omentum flaps to wrap the anastomotic stoma, which increases the biliary tract blood supply, may reduce the incidence of bile leak.


METHODS
Fourteen patients undergoing piggy-back liver transplantation and having poor biliary tract conditions were treated with pedicled greater omentum flaps to wrap the anastomotic stoma of the biliary tract. Their clinical data were analyzed retrospectively.


RESULTS
Of the 14 patients, only one (7.1%) had a mild bile leak on the 8th day post-operation and fully recovered after symptomatic treatment. The other patients had no biliary complications.


CONCLUSIONS
Using pedicled greater omentum flaps to wrap the anastomotic stoma of the biliary tract is an effective way to prevent bile leak in liver transplantation patients, especially those with poor biliary tract conditions. However, experience with this surgical technique still needs to be further explored.
Ye
Qi-Fa
QF
Research Center of National Health Ministry on Transplantation Medicine Engineering and Technology, Third Xiangya Hospital, Central South University, Changsha 410013, China. yqf_china@163.com
Niu
Ying
Y
She
Xing-Guo
XG
Ming
Ying-Zi
YZ
Cheng
Ke
K
Ma
Yin
Y
Ren
Zu-Hai
ZH
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D001649:Bile Duct Diseases / Q000209:etiology / Q000517:prevention & control*; D001652:Bile Ducts / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome