Biliary reconstruction without T-tube in liver transplantation

Transplant Proc. 2004 May;36(4):951-2. doi: 10.1016/j.transproceed.2004.03.103.

Abstract

Biliary complications have been reported in 9% to 34% of liver transplant patients. Although most centers seem to prefer a duct-to-duct anastomosis without a T-tube when feasible, the best method of biliary reconstruction remains controversial. The aim of this study was to review our experience on reconstruction of the biliary tract without drainage. Forty-one patients underwent 45 liver transplants over two periods. Forty patients underwent 15 liver transplants from October 1992 to March 1995; and 27 underwent 30 liver transplants from January 2002 to February 2003. Our standard biliary reconstruction was an end-to-end anastomosis without drain. The overall actuarial survival was 72.7% at 1 year, 64.7% at 3 years, and 56.6% at 5 years. The mean follow-up was 23 months. Eight patients (22.2%) developed biliary tract complications: five patients papillary dysfunction (13.9%); two, biliary stricture (5.5%); and one, biliary sludge without evidence of stricture (2.8%). Papillary dysfunction represented 62.5% of all complications. Biliary reconstruction without drainage may be routinely performed since the complications are only those not related to the T-tube.

MeSH terms

  • Anastomosis, Surgical
  • Bile Ducts / surgery*
  • Choledochostomy
  • Humans
  • Liver Transplantation / methods*
  • Liver Transplantation / mortality
  • Plastic Surgery Procedures / methods*
  • Retrospective Studies
  • Survival Analysis
  • Time Factors