Outcomes of surgical repair of bile leaks and strictures after adult-to-adult living donor liver transplant.
We sought to determine factors that predict the successful surgical repair of biliary complications after adult living donor liver transplantation (ALDLT).


METHODS
Records of 82 consecutive ALDLT right lobe recipients were reviewed. Operations were performed on 19 recipients for biliary complications. Post-operative biliary complications were analyzed. Fisher's exact test was used to identify variables that correlated with successful surgical repair.


RESULTS
A total of 29 recipients had biliary complications, of which 19 had a surgical repair. The five recipients, operated on for a stricture without history of leaks, did not develop further complications. However, nine of 14 with a history of a leak developed further complications after surgical repair (p-value = 0.044). All five who presented with a biliary complication more than 100 d after transplant had successful surgical repair; however, nine out of 13 who presented within 57 d had additional complications after repair.


CONCLUSIONS
Operations for strictures after ALDLT are more successful than operations for leaks. Recipients with isolated biliary strictures after ALDLT can be managed surgically; however, recipients with history of a leak often require additional interventions after surgical repair.
Melcher
Marc L
ML
Surgery, Division of Multiorgan Transplantation, Stanford University Medical Center, Stanford Surgery, UCSF, Stanford, CA, USA.
Freise
Chris E
CE
Ascher
Nancy L
NL
Roberts
John P
JP
D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000473:pathology* / Q000601:surgery*; D001660:Biliary Tract Diseases / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult