title: Surgical treatment of biliary tract complications after liver transplantation.
abstract: OBJECTIVE
  Biliary strictures are the most common biliary tract complication after liver transplantation. There are scarce data on the results of hepaticojejunostomy (HJ) in the management of biliary complications after orthotopic liver transplantation (OLT). Thus, the role of surgery in this setting remains to be established. The aim of this study was to evaluate the results of surgical treatment of patients with biliary complications at our institution.
  
  
  METHODS
  We reviewed 1000 consecutive liver transplantations performed at our institution from 1984 to 2007. We used a prospectively recorded database to identify patients who underwent HJ to treat any biliary tract complication.
  
  
  RESULTS
  Overall, 62 patients (6.2%) underwent HJ, 40 for an anastomotic and 7 for a non-anastomotic stricture as well as 15 for biliary leaks. Postoperative morbidity was 16%, and postoperative mortality 1.6%. There were 7 cases of anastomotic stenosis (11.3%). Four patients (5%) required retransplantation.
  
  
  CONCLUSIONS
  HJ is a safe procedure to manage biliary complications after OLT. It may be the first treatment choice especially for cases with anastomotic strictures.
authors: Department of Surgery, Liver Transplant Unit, Hospital Universitari de Bellvitge, Barcelona, Spain. 3151311g@comb.cat
authors: L
authors: L
authors: Lladó
authors: J
authors: J
authors: Fabregat
authors: C
authors: C
authors: Baliellas
authors: A
authors: A
authors: Gonzalez-Castillo
authors: E
authors: E
authors: Ramos
authors: E
authors: E
authors: Gonzalez-Vilatarsana
authors: J
authors: J
authors: Torras
authors: A
authors: A
authors: Rafecas
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001660:Biliary Tract Diseases / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002779:Cholestasis / Q000209:etiology / Q000601:surgery; D003251:Constriction, Pathologic; D004724:Endoscopy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D007582:Jejunostomy; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013030:Spain; D016896:Treatment Outcome