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Biliary complications in one hundred adult liver transplantations
A Koivusalo1, H Isoniemi, K Salmela
1Fourth Dept. of Surgery, Helsinki University Central Hospital, Finland.
Background:
Biliary complications are a common problem in liver transplantation (LT).
Methods:
We reviewed 100 consecutive adult LTs, including 10 retransplantations. Ten patients who survived for less than 1 month or developed hepatic artery thrombosis were excluded. Biliobiliary anastomosis was performed with a T-tube (CCT) (n = 25) or without it (CC) (n = 59), or biliodigestive anastomosis (Rouxen-Y) (n = 6) was used.
Results:
Biliary complications (8 anastomotic strictures and 9 bile leakages) occurred in 15 LTs. Surgical treatment was needed for seven strictures and two leakages. Complications tended to be more frequent with CCT than with CC (24% versus 12%). Biliary complications were often accompanied by cytomegalovirus disease and bacterial infections. After a median follow-up time of 5.2 years, total patient survival was 71% for all 100 LTs and 81% for those with biliary complications.
Conclusions:
Biliary complications are rather frequent after LTs; they are often preceded by infections but can be treated and do not cause excessive mortality. T-tubes are not to be recommended.