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Volume: 6 Issue: 4 November 2008 - Supplement - 1



Biliary complications are some of the most significant problems in liver transplant. Although T tubes and stents are widely used for routine biliary reconstruction during liver transplant, they have inherent complications, and there is no proof that they are beneficial to healing. In this report, we describe our results of biliary reconstruction without stenting in deceased and living-donor liver transplant recipients. Between January 2001 and July 2008, 238 liver transplants were done at our center. Before December 2006, we used different drainage techniques for biliary reconstruction including T tubes, straight feeding tubes, and transhepatic catheters. Since December 2006, we have done biliary reconstructions without a drainage catheter for both deceased and living-donor liver transplant recipients. After December 2006, 97 liver transplants were done for 94 recipients (62 male, 32 female patients; median age, 25.2 ± 20.7 years; range, 0.5-60 years) whose cases were reviewed retrospectively. Forty-one of these 94 recipients were children, 16 of them were under the age of 1 year at the time of liver transplant. Biliary reconstruction was done with a duct-to-duct anastomosis in 74 recipients and with a Roux-en-Y hepaticojejunostomy in 23. Seventy of the 97 grafts had single bile duct, 22 grafts had 2 bile ducts, 4 grafts had 3 bile ducts, and 1 graft had 4 bile ducts. During a mean follow-up of 8.74.7 months (range, 1-17 months), our overall biliary complication rate was 13.4% (n=13). Bile leak occurred in 5 recipients (5.1%), biliary stenosis in 7 recipients (7.2%), and concomitant bile leak and stenosis in 1 recipient (1.1%). All biliary complications were treated using interventional radiology techniques. At the time of this writing, 12 recipients had died, and the remaining 85 recipients (87.2%) were alive. In conclusion; biliary reconstruction without using a stent is safe for both deceased and living-donor liver transplants, even for the pediatric recipients.

Volume : 6
Issue : 4
Pages : 147

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Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey