Intrahepatic Bilioenteric Anastomosis After Biliary Complications of Liver Transplantation: Operative Rescue of Surgical Failures

Mercado, Miguel Ángel; Vilatobá, Mario; Chan, Carlos; Domínguez, Ismael; Leal, Rafael; Olivera, Marco

doi:10.1007/s00268-008-9876-2

Cited by 7 publications

(1 citation statement)

References 16 publications

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“…4, 5) but also more proximal segments of the biliary tree can be connected to the jejunum. Incision or resection of liver parenchyma to gain adequate access to the proximal bile ducts might be necessary [10]. In general, proximal anastomosis is technically better feasible to the left hepatic duct due to a longer and more superficial extrahepatic course than the right hepatic duct.…”

Section: Reoperation For Early Bile Leaksmentioning

confidence: 99%

Leakage of Hepaticojejunal Anastomosis: Reoperation

Wellner

Keck

2017

Visc Med

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Background: Leakage of a hepaticojejunal anastomosis is a rare event with potential major morbidity. Surgeons must be aware of the technical armamentarium and pitfalls in revisional surgery for hepaticojejunal anastomosis leakage. Methods: Review of the available literature and discussion of technical details based on experience and expert opinion. Results: Early bile leaks as well as failed interventional therapy are indications for reoperation. Almost all reports only mention rates of leakage as a secondary endpoint but do not report details of treatment and outcome. Few authors have compared outcome after reoperation versus interventional approaches in observational studies, with the latter resulting in lower morbidity. The complex and individual situation of the complication makes evidence-based argumentation difficult; this is why personal expert opinions have to be taken into account in this review. The technical aspects and pitfalls of revisional surgery are outlined but represent anecdotal evidence as comparative studies are lacking. Conclusion: Bile leak after bilioenteric anastomosis is a rare condition that requires differentiated workup and therapy. Early leaks usually result from technical problems and are amenable to repair by reoperation. Reoperation technique can only be discussed on a low evidence level.

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Section: Reoperation For Early Bile Leaksmentioning

confidence: 99%