Bile duct splintage in liver transplantation: is it necessary?

Transplant International : Official Journal of the European Society for Organ Transplantation
B H Ferraz-NetoP McMaster

Abstract

The choledochochole-dochal (duct-duct, D-D) anastomosis in orthotopic liver transplantation (OLT) is usually splinted by a T-tube to facilitate easy cholangiography, monitor bile quality and allow biliary decompression. T-tubes, however, are a focus for sepsis and sludge deposition, and their removal may result in bile leakage. From January 1993 to December 1994, 199 consecutive adult OLTs in 183 patients (median age 50 years, range 16-69 years, 118 females) with a D-D anastomosis were studied prospectively with a median follow-up of 16 (3-27) months. Of the 199 OLTs, 110 had an 8 Fr T-tube (group 1) and 89 had no T-tube (group 2). The two groups were similar for indication, preservation solution, median cold and warm ischaemia times and early graft function parameters. Biliary complications developed in 26/110 patients, including 10 with bile leaks on T-tube removal in group 1 compared to 10/89 biliary complications in group 2 (P = 0.024). The use of T-tubes is associated with increased morbidity and their routine use should be discontinued.

References

Jan 1, 1995·Transplant International : Official Journal of the European Society for Organ Transplantation·C ChardotD Mayer
Mar 1, 1995·Archives of Surgery·T P O'ConnorR L Jenkins

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Citations

Jul 10, 2001·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·J PirenneP McMaster
May 11, 2002·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Sudeep R ShahBrian R Davidson
Dec 1, 2004·Seminars in Interventional Radiology·Nishita KotharyRichard D Shlansky-Goldberg
Jul 31, 2012·Transplantation Proceedings·M GastacaJ Ortiz de Urbina
Jun 24, 2008·The Medical Clinics of North America·Alan Koffron, Julie A Stein
Dec 4, 2010·Journal of Hepato-biliary-pancreatic Sciences·Fabio Colagrossi Paes-BarbosaL A Szutan
Apr 30, 2011·Journal of Zhejiang University. Science. B·Wei-dong HuangYuan-qiang Lu
Apr 21, 2006·Transplant International : Official Journal of the European Society for Organ Transplantation·Balázs NemesMaarten J H Slooff
Jun 20, 2006·Scandinavian Journal of Gastroenterology. Supplement·Robert C VerdonkElizabeth B Haagsma
Dec 23, 2015·World Journal of Hepatology·Riccardo MemeoPatrick Pessaux

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