Biliary anastomotic complications in 400 living related liver transplantations

Citation
H. Egawa et al., Biliary anastomotic complications in 400 living related liver transplantations, WORLD J SUR, 25(10), 2001, pp. 1300-1307
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
WORLD JOURNAL OF SURGERY
ISSN journal
0364-2313 → ACNP
Volume
25
Issue
10
Year of publication
2001
Pages
1300 - 1307
Database
ISI
SICI code
0364-2313(200110)25:10<1300:BACI4L>2.0.ZU;2-8
Abstract
The purpose of this study was to evaluate the cause and outcome of biliary anastomotic complications occurring after living related liver transplantat ion (LRLT). A database of 391 patients undergoing 400 LRLT from June 1990 t o August 1998 was reviewed. The overall incidence of biliary anastomotic co mplications was 18.2% (71 patients). There were 45 bile leaks, 35 anastomot ic strictures, and the bile duct was ligated inadvertently in 3 cases. Univ ariative analysis revealed that the manner of stent usage, intrapulmonary s hunting, and gender of recipients were significant risk factors for leakage . Anastomotic leaks', cytomegalovirus infection, hepatic artery complicatio ns, and gender or recipients were significant risk factors for stricture. I n pediatric patients older than 2 years old, ABO blood type compatibility w as another risk factor for leakage and stricture. Choice of stent usage and earlier transplantation for patients with intrapulmonary shunting should r educe the rate of biliary leaks, and prophylaxis of leaks for patients with intrapulmonary shunting, and minimizing hepatic artery complications shoul d reduce the rate of biliary stricture after LRLT. Avoidance of ABO-incompa tible donors or innovative immunosuppression in ABO-incompatible transplant ation should be considered in children.