title: Experience using liver transplantation for the treatment of severe bile duct injuries over 20 years in Argentina: results from a National Survey.
abstract: BACKGROUND
  Bile duct injury (BDI) is a severe complication that may arise during the surgical treatment of benign disease and a few patients will develop end-stage liver disease (ESLD) requiring a liver transplant (LT).
  
  
  OBJECTIVE
  Analyse the experience using LT as a definitive treatment of BDI in Argentina.
  
  
  METHODS
  A national survey regarding the experience of LT for BDI.
  
  
  RESULTS
  Sixteen out 18 centres reported a total of 19 patients. The percentage of LT for BDI from the total number of LT per period was: 1990-94 = 3.1%, 1995-99 = 1.6%, 2000-04 = 0.7% and 2005-09 = 0.2% (P < 0.001). The mean age was 45.7 ± 10.3 years (range 26-62) and 10 patients were female. The BDI occurred during cholecystectomy in 16 and 7 had vascular injuries. One patient presented with acute liver failure and the others with chronic ESLD. The median time between BDI and LT was 71 months (range 0.2-157). The mean follow-up was 8.3 years (10 months to 16.4 years). Survival at 1, 3, 5 and 10 years was 73%, 68%, 68% and 45%, respectively.
  
  
  CONCLUSIONS
  The use of LT for the treatment of BDI declined over the review period. LT plays a role in selected cases in patients with acute liver failure and ESLD.
authors.affiliation: General Surgery Service and Liver Transplant Unit, Hospital Italiano de Buenos Aires General Surgery and Liver Transplant Unit, Hospital Alemán de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Victoria
authors.initials: V
authors.lastname: Ardiles
authors.forename: Lucas
authors.initials: L
authors.lastname: McCormack
authors.forename: Emilio
authors.initials: E
authors.lastname: Quiñonez
authors.forename: Nicolás
authors.initials: N
authors.lastname: Goldaracena
authors.forename: Juan
authors.initials: J
authors.lastname: Mattera
authors.forename: Juan
authors.initials: J
authors.lastname: Pekolj
authors.forename: Miguel
authors.initials: M
authors.lastname: Ciardullo
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Santibañes
mesh_terms: D000328:Adult; D001118:Argentina; D001652:Bile Ducts / Q000293:injuries*; D016009:Chi-Square Distribution; D002763:Cholecystectomy / Q000009:adverse effects; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D058625:End Stage Liver Disease / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D019538:Health Care Surveys; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease; D017114:Liver Failure, Acute / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome