[Use of drains in the biliary tract in liver transplantation]

Between January 1995 and December 1997 42 liver transplantations were performed in Centre for cardiovascular surgery and transplantation's in Brno. The patients were divided into two groups. The first group consist of 27 transplantations, where the biliary reconstruction was performed by means of choledochocholedochostomy or choledochojejunostomy over a drain. The drain was used on the first 20 patients for initial irrigation and for the decompression of the biliary tree later on. It was used only for the decompression in the last 7 patients of this group. The second group consist of 14 patients, where the choledochocholedochostomy was performed without any drain. The rate of the biliary complications was significantly higher in the first group. Nine biliary obstructions, 6 leaks a and 6 cholangitis occurred. Four patients died in consequence of the biliary complications. There was no biliary complication in the second group. Choledochocholedochostomy without a drain is considered as a method of choice for biliary tract reconstruction in liver transplantation.