Biliary complications after living donor liver transplantation

Wang, Shao Fa; Huang, Zhi; Chen, Xiao Ping

doi:10.1002/lt.22381

Cited by 114 publications

(93 citation statements)

References 84 publications

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“…Other sources include cut surfaces of liver grafts, cystic duct, drainage tube exit sites, and sinus tracts. 5,31,40,41 Similarly, in our study, all bile leaks manifested in the first 1 to 2 months after transplant, with the majority being anastomotic leaks (30/32; 93.75%) and a minority being leaks from the graft cut surface (2/32; 6.25%). On the other hand, biliary strictures are generally classified into anastomotic and nonanastomotic strictures (ischemic-type biliary lesions), with anastomotic strictures being much more common.…”

Section: Discussionsupporting

confidence: 77%

“…5 Approximately one-third of biliary complications occur within the first month after transplant, twothirds occur within the first 3 months, and nearly Anastomotic bile leak due to complete disruption of 1 of 2 duct-to-duct biliary anastomoses is shown. A peritoneal lavage and drainage with redo biliary reconstruction via Roux-en-Y hepaticojejunostomy was performed.…”

Section: Discussionmentioning

confidence: 99%

“…Biliary strictures and bile leaks account for most biliary complications after livingdonor liver transplant (LDLT), and the outcomes are potentially lethal. 5 The aim of this retrospective cohort study, which we conducted in 2014 and 2015, was to review our experiences with biliary complications in 120 patients who underwent LDLT over a 9-year period and to evaluate the efficacy of different treatment modalities in the management of different types of biliary complications.…”

Section: Introductionmentioning

confidence: 99%

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Sarhan

Osman²,

Mohamed³

et al. 2017

Exp Clin Transplant

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Objectives: Biliary complications are common after living-donor liver transplant. This retrospective study reviewed our experience with biliary complications in recipients of living-donor liver transplant. Materials and Methods: Over our 9-year study period, 120 patients underwent living-donor liver transplant. Patients were divided into 2 groups, with group A having biliary complications and group B without biliary complications. Both groups were compared, and different treatment modalities for biliary complications were evaluated. Results: Group A included 45 patients (37.5%), whereas group B included 75 patients (62.5%). Biliary complications included bile leak in 17 patients (14.2%), biliary stricture in 11 patients (9.2%), combined biliary stricture with bile leak in 15 patients (12.5%), and sphincter of Oddi dysfunction and cholangitis in 1 patient each (0.8%). Cold ischemia time was significantly longer in group A (P = .002). External biliary drainage was less frequently used in group A (P = .031). Technical success rates of endoscopic biliary drainage and percutaneous transhepatic biliary drainage were 68.3% and 41.7%. Survival rate following relaparotomy for biliary complications was 62.5%. Conclusions: Graft ischemia is an important risk factor for biliary complications. Bile leaks can predispose to anastomotic strictures. The use of external biliary drainage seems to reduce the incidence of biliary complications. Endoscopic and percutaneous transhepatic approaches can successfully treat more than twothirds of biliary complications. Relaparotomy can improve survival outcomes and is usually reserved for patients with intractable biliary complications.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Untitled

Sarhan

Osman²,

Mohamed³

et al. 2017

Exp Clin Transplant

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“…However, end-to-end ductal anastomisis with a small duct (< 4 mm in diameter) is associated with a higher risk of biliary strictures than HJ. 4,7,8 …”

Section: End-to-end Ductal Anastomosis In Liver Transplantationmentioning

confidence: 99%

End-to-end ductal anastomosis in biliary reconstruction: indications and limitations

Jabłońska

2014

cjs

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“…bile duct stricture (biliary stricture) occur after orthotopic liver transplantation (OLT) in 10-25% of cases [1,2]. With the development of anastomotic stricture between donor and recipient bile duct parts, the method of choice for its correction is endoscopic balloon cholangioplasty with subsequent placement of a temporary stent.…”

mentioning

confidence: 99%

Biliary Manometric Perfusion Test in Evaluating the Efficacy of Balloon Cholangioplasty for Non-Anastomotic Biliary Strictures after Orthotopic Liver Transplantation

Поликарпов¹,

Таразов²,

Полехин³

et al. 2017

Sovrem Tehnol Med

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The aim of the study was to determine the role of biliary manometric perfusion test in evaluating the efficacy of percutaneous balloon cholangioplasty (balloon dilation) for biliary strictures in patients after orthotopic liver transplantation (OLT).Materials and Methods. During the period of 1998-2016, 168 patients underwent 179 OLTs in the Russian Research Center for Radiology and Surgical Technologies named after Academician A.M. Granov (Saint Petersburg). Non-anastomotic biliary strictures requiring interventional radiological procedures occurred in 15 patients (8.4% of the total number of OLTs) within 3 to 62 months after surgery.The study involved 6 patients who underwent 43 stricture dilations (3 to 14) with balloon catheters of 4 to 8 mm diameter after percutaneous transhepatic cholangiodrainage. External-internal cholangiodrainage of 8 F diameter was left in place after bilioplasty. Treatment procedures were repeated under intravenous anesthesia once in 2-3 months.biliary manometric perfusion test was performed after positive X-ray control of biliary patency within 6 to 17 months from the beginning of bilioplasty. The drains were removed from the guidewire, introducers of 9-10 F diameter were placed in the bile duct above the stricture. 30% solution of Ultravist-350 was infused into the ducts in the following modes: 4 ml/min during 5 min; 8 ml/min -5 min; 15 ml/min -3 min; 20 ml/min -2 min. Fluid pressure was measured within the ducts before and after the infusion. The result of balloon dilation was considered successful if the pressure before and after the infusion did not exceed 200 mm WG. In these cases, externalinternal drain was removed.Results. based on the manometry data, 9 drains were successfully removed in all 6 patients during the period of 8 to 22 months from the time of cholangiodrainage. The patients were followed up for 4 to 40 months without radiographic and biochemical signs of biliary hypertension and cholestasis.Conclusion. biliary manometric perfusion test may serve as an effective minimally invasive method to control the efficacy of balloon cholangioplasty for biliary strictures in patients after orthotopic liver transplantation.

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Biliary complications after living donor liver transplantation

Cited by 114 publications

References 84 publications

Untitled

Untitled

End-to-end ductal anastomosis in biliary reconstruction: indications and limitations

Biliary Manometric Perfusion Test in Evaluating the Efficacy of Balloon Cholangioplasty for Non-Anastomotic Biliary Strictures after Orthotopic Liver Transplantation

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