Las complicaciones biliares en el trasplante hepático de donante vivo no afectan los resultados a largo plazo

Sánchez‐Cabús, Santiago; Calatayud, David G.; Garcia-Roca, Raquel; Ferrer, Joana; Martı́, Josep; Navasa, Miquel; Rimola, Antoni; Fondevila, Constantino; Fuster, J.; García‐Valdecasas, Juan Carlos

doi:10.1016/j.ciresp.2012.07.012

Cited by 5 publications

(6 citation statements)

References 26 publications

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“…Altogether, biliary stenoses appeared late after the LDLT procedure, and although their rate was lower than in our previously published study [7], we are sure that this issue is important enough to warrant a larger trial that may assess the efficacy of RBS placement. In the literature, there is a considerable difference between published data about biliary complications after adult LDLT, but they have to be somewhere between 25 and 45%.…”

Section: Discussionmentioning

confidence: 53%

“…In fact, these complications should not be regarded as a whole but a sum of two distinct entities that arise in the postoperative period: the biliary leak, usually diagnosed in the first days after LDLT and frequently treated successfully without the need for a surgical reintervention, and biliary stenoses, which may be influenced by the previous appearance of a biliary leak, are characteristically diagnosed a long time after the LDLT procedure, and are often difficult to treat, leading sometimes to long-term parenchymal problems, such as secondary biliary cirrhosis, if not appropriately treated. Indeed, many publications have addressed this particular issue since the beginning of LDLT, and in our experience, these complication were not negligible [7]. …”

Section: Discussionmentioning

confidence: 99%

“…This high rate of biliary complications appears to be related to various reasons which do not usually occur in the whole hepatic graft: first, in a high percentage of grafts, more than one bile duct is found, multiplying the number of anastomoses needed for the reconstruction; second, bile ducts from a partial graft have a small diameter (about 2-4 mm), which represents a surgical challenge, and third, the graft's bile duct might have an impaired vascular irrigation. This concept is suggested by the experience that most biliary stenoses appear and become symptomatic beyond 6 months after LDLT [7]. …”

Section: Introductionmentioning

confidence: 99%

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Beneficial Effect of a Resorbable Biliary Stent in Living Donor Liver Transplantation

Sánchez‐Cabús

Calatayud²,

Ferrer³

et al. 2016

Eur Surg Res

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Background: Living donor liver transplantation (LDLT) entails a significant number of bile duct complications. We aimed to diminish the biliary complication rate with the use of a resorbable biliary stent (RBS) during LDLT. The objective of this study is to describe the surgical techniques and the associated outcomes, especially in terms of safety, of RBS use in LDLT. Methods: From 2011 to 2014, 12 LDLT recipients were enrolled in a clinical trial with the use of a specifically designed RBS. These patients were followed according to the clinical protocol. Specific complications derived from RBS as well as biliary complications were recorded. Results: One patient underwent early retransplantation due to a small-for-size syndrome. None of the patients had a complication attributable to the placement, remaining in place, or degradation of the stent. Four of the remaining patients presented with a biliary complication: 1 (9.1%) with a biliary leak alone, 1 (9.1%) with a biliary stenosis alone, and 2 (18.2%) with both. However, none of the leaks could be directly attributed to the RBS. Patient and graft 1-year survival was 100 and 91.7%, respectively. Conclusion: The use of an RBS in LDLT is not associated with complications, and initial results regarding efficacy and safety are encouraging. The need for a larger and prospective study is warranted.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Beneficial Effect of a Resorbable Biliary Stent in Living Donor Liver Transplantation

Sánchez‐Cabús

Calatayud²,

Ferrer³

et al. 2016

Eur Surg Res

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“…Very infrequently, tubular embolization or re-surgery is needed. 256 Ischemic bile duct injuries. These may have various etiologies, such as ABO incompatibility, artery thrombosis, ischemia/reperfusion injury, among others, 12 and are among the most common complications (15-37%) in patients who received livers from DCD donors.…”

Section: Surgical Complications Vascular Complicationsmentioning

confidence: 99%

“…12 Around half of the cases need re-surgery, and the duct-to-duct anastomosis becomes a hepaticojejunostomy (Grade III). 256 Bowel perforation. Bowel perforation is a potentially devastating complication after LT in the pediatric population.…”

Section: Surgical Complications Vascular Complicationsmentioning

confidence: 99%

Clinical Practice Guidelines for Liver Transplantation in Saudi Arabia

Abaalkhail

Sebayel

Shagrani

et al. 2021

SMJ

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The first human liver transplantation (LT) in the Kingdom of Saudi Arabia (KSA) was performed in 1990, but the first LT program was commenced in 1994. 1 Until 1997, all LTs in KSA were from deceased donors. 1,2 The living donor LT (LDLT) program for children started in 1997, and the LDLT program for adults was initiated in 2001. 3 Thus, as of 2017, there were 2,233 LTs conducted: 1,133 livers from livingrelated donors, 95 from living-unrelated donors, and

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Do We Need to Use a Stent in Biliary Reconstruction to Decrease the Incidence of Biliary Complications in Liver Transplantation? A Systematic Review and Meta-Analysis

Elkomos

Abdelaal

2023

Journal of Gastrointestinal Surgery

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Background and Aim Biliary complications are a significant cause of morbidity post-transplantation, and the routine use of biliary stents in liver transplantation to reduce these complications remains controversial. This study aimed to compare the incidence of biliary complications with and without the use of trans anastomotic biliary stent in liver transplantation. Method PubMed, Scopes, Web of Science, and Cochrane library were searched for eligible studies from inception to February 2022, and a systematic review and meta-analysis were done to compare the incidence of biliary complications in the two groups. Results Seventeen studies with a total of 2623 patients were included. The pooled results from the included studies showed an equal rate of biliary complications (i.e., strictures, leaks and cholangitis) in stented and non-stented patients after liver transplantation. However, the cost and biliary intervention rates are higher in stented patients. In addition to that, our sub-group analysis showed no significant decrease in the incidence of biliary complications after using trans anastomotic biliary stent in living donor liver transplant (LDLT), deceased donor liver transplant (DDLT), Roux-en-Y hepaticojejunostomy (RYHJ), and duct-to-duct anastomosis, pediatric, and adult liver transplantation. Conclusion No added benefit on the routine use of endobiliary stent in liver transplantation. However, stented patients are at higher risk of needing multiple ERCPs.

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Las complicaciones biliares en el trasplante hepático de donante vivo no afectan los resultados a largo plazo

Cited by 5 publications

References 26 publications

Beneficial Effect of a Resorbable Biliary Stent in Living Donor Liver Transplantation

Beneficial Effect of a Resorbable Biliary Stent in Living Donor Liver Transplantation

Clinical Practice Guidelines for Liver Transplantation in Saudi Arabia

Do We Need to Use a Stent in Biliary Reconstruction to Decrease the Incidence of Biliary Complications in Liver Transplantation? A Systematic Review and Meta-Analysis

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