Rubber transcystic drainage reduces the post-removal biliary complications in liver transplantation: a matched case-control study.
Langenbecks Arch Surg
; 398(1): 169-76, 2013 Jan.
Article
in En
| MEDLINE
| ID: mdl-22718298
ABSTRACT
PURPOSE:
Bile duct (BD) complications continue to be the "Achilles' heel" of liver transplantation, and the utilization of bile duct drainage is still on debate. We describe the results of a less invasive rubber trancystic biliary drainage (TBD) compared to a standard silicone T-tube (TT).METHODS:
The transplanted patients (n = 248), over a period of 5 years with a TBD (n = 20), were matched 12 with control patients with a TT (n = 40). Primary end points were the overall incidence of BD complications and graft and patient survival. Secondary end points included the complications after the drainage removal.RESULTS:
Although the bile duct leakage rates were not significantly different between both groups, the TT group had a significantly higher rate of overall 1-year BD stenosis (40 versus 10 %) (p = 0.036). Three-year patient/graft survival rates were 83.2/80.1 and 84.4/84.4 % for the TT and TBD groups, respectively. The postoperative BD complications, after drainage removal (peritonitis and stenosis), were significantly reduced (p = 0.011) with the use of a TBD.CONCLUSION:
The use of rubber TBD in liver transplant recipients does not increase the number of BD complications compared to the T-tube. Furthermore, less BD anastomotic stenosis and post-removal complications were observed in the TBD group compared to the TT group.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Rubber
/
Drainage
/
Biliary Fistula
/
Liver Transplantation
/
Cystic Duct
/
Anastomotic Leak
Type of study:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Langenbecks Arch Surg
Year:
2013
Document type:
Article
Affiliation country:
France
Publication country:
ALEMANHA
/
ALEMANIA
/
DE
/
DEUSTCHLAND
/
GERMANY