[Role of surgery in the management of biliary complications after liver transplantation].

Abstract:

UNLABELLED:Management of biliary tract complications (BTC) after liver transplantation (LT) has progressed in recent years. The aims of this study were, to analyse the incidence and management in our institution of BTC after 1000 LT; and to study the management of patients with anastomotic strictures (AS). RESULTS:The incidence of BTC was 23%. There were 76 cases of bile leak, 106 cases of anastomotic strictures, 46 non-anastomotic strictures, 42 choledocolithiasis and 19 other complications. Among 106 cases of anastomotic strictures, radiological treatment, either PTC or ERCP, was initially indicated in 62. The AS of 38 patients (33%) were resolved with surgical treatment, 18 of them after a previous attempt at radiological treatment. Patients who were treated initially by radiologically required more procedures. Morbidity and mortality related to BTC were slightly higher in the group of patients treated by radiology (morbidity: surgical: 4 (18%) vs. radiological: 20 (32%); p=0.2 and mortality: surgical: 0% vs. radiological: 8 (11%); p=0.23). Among 46 patients with non-anastomotic strictures, 29 were resolved with retransplantation (63%). CONCLUSIONS:Surgery has a significant role in the management of BTC, and is the treatment of choice in some cases of anastomotic strictures. Retransplantation may be the preferred option in patients with non-anastomotic strictures.

journal_name

Cir Esp

journal_title

Cirugia espanola

authors

Lladó L,Fabregat J,Ramos E,Baliellas C,Torras J,Julià D,Berrozpe A,Jorba R,Rafecas A

doi

10.1016/j.ciresp.2010.03.010

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

364-71

issue

6

eissn

0009-739X

issn

1578-147X

pii

S0009-739X(10)00122-3

journal_volume

87

pub_type

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