title: Laparoscopic treatment of biliary peritonitis after removal of T-tube in liver transplant patients.
abstract: BACKGROUND
  T-tube removal in liver transplant patients can occasionally cause a massive biliary leak and may require surgical treatment for its resolution. We present our experience with a laparoscopic approach to biliary peritonitis in liver transplant patients after the removal of a T-tube.
  
  
  METHODS
  From January 2003 until February 2010, we performed 351 liver transplantations in 313 recipients, including 135 with a T-tube. After its removal 31 biliary leaks developed (23%); 12 were massive and required surgery, which utilized a laparoscopic approach.
  
  
  RESULTS
  The mean length of the intervention was 72.9 ± 12.87 minutes (range = 55-95), without any complications during the procedure, and no need to convert to a laparotomy. Mean hospital stay after the intervention was 6.75 ± 3.88 days (range 4-18). There was no mortality from the procedure.
  
  
  CONCLUSIONS
  The laparoscopic approach for biliary leakage after T-tube removal is indicated when large diffuse acute peritonitis is established a few hours postremoval of the T-tube. This safe procedure treats the complication without the need for another laparotomy.
authors: Department of Surgery, Liver Transplant Unit, Virgen de la Arrixaca University Hospital, Murcia, Spain. cascalex@yahoo.es
authors: P
authors: P
authors: Cascales Campos
authors: P
authors: P
authors: Ramírez Romero
authors: R
authors: R
authors: González
authors: J A
authors: JA
authors: Pons
authors: M
authors: M
authors: Miras
authors: F
authors: F
authors: Sanchez Bueno
authors: R
authors: R
authors: Robles
authors: P
authors: P
authors: Parrilla
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology / Q000601:surgery*; D001660:Biliary Tract Diseases / Q000209:etiology / Q000601:surgery*; D002768:Choledochostomy / Q000295:instrumentation*; D020878:Device Removal / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D016031:Liver Transplantation / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome