Biliary Duct-to-Duct Reconstruction with a Tunneled Retroperitoneal T-Tube During Liver Transplantation: a Novel Approach to Decrease Biliary Leaks After T-Tube Removal.
The benefit of placing a T-tube for duct-to-duct biliary reconstruction during orthotopic liver transplantation (OLT) remains controversial because it could be associated with specific complications, especially at the time of T-tube removal. While the utility of T-tube during OLT represents an eternal debate, only a few technical refinements of T-tube placement have been described since the report of the original technique by Starzl and colleagues. Herein, we present a novel technique of T-tube placement for duct-to-duct biliary reconstruction during OLT, using a tunneled retroperitoneal route. On the basis of our experience of 305 patients who benefitted from the reported technique, the placement of a tunneled retroperitoneal biliary T-tube appears to be safe and results in a low rate of biliary complications, especially at the time of T-tube removal.
Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Croix-Rousse University Hospital, 103, Grand Rue de la Croix-Rousse, Lyon, Cedex 04, 69317, France.
Julie
J
Navez
Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Croix-Rousse University Hospital, 103, Grand Rue de la Croix-Rousse, Lyon, Cedex 04, 69317, France. kayvan.mohkam@chu-lyon.fr.|Ecole Doctorale EDISS 205, Université Lyon 1, EMR 3738, Lyon, France. kayvan.mohkam@chu-lyon.fr.
Kayvan
0000-0002-9695-0902
K
Mohkam
Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Croix-Rousse University Hospital, 103, Grand Rue de la Croix-Rousse, Lyon, Cedex 04, 69317, France.
Benjamin
B
Darnis
Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Croix-Rousse University Hospital, 103, Grand Rue de la Croix-Rousse, Lyon, Cedex 04, 69317, France.
Jean-Baptiste
JB
Cazauran
Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Croix-Rousse University Hospital, 103, Grand Rue de la Croix-Rousse, Lyon, Cedex 04, 69317, France.
Christian
C
Ducerf
Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Croix-Rousse University Hospital, 103, Grand Rue de la Croix-Rousse, Lyon, Cedex 04, 69317, France.|Ecole Doctorale EDISS 205, Université Lyon 1, EMR 3738, Lyon, France.
Jean-Yves
JY
Mabrut
D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D057868:Anastomotic Leak / Q000209:etiology / Q000517:prevention & control*; D001652:Bile Ducts / Q000601:surgery*; D001660:Biliary Tract Diseases / Q000209:etiology / Q000517:prevention & control*; D020878:Device Removal / Q000009:adverse effects; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*
Bile leakage; Biliary reconstruction; Liver transplantation; Peritonitis; T-tube