Operative techniques in liver transplantation and biliary complications

doi:10.3969/j.issn.2095-4344.2014.27.007

Abstract

Abstract:

BACKGROUND: Previous studies have reported the cause and treatment of biliary complication. However, how to improve operative technique for preventing the complication is rarely reported.
OBJECTIVE: To explore the effect of operational skills during liver transplantation on biliary complications.
METHODS: Biliary complications in 475 patients who underwent liver transplantation were retrospectively analyzed. The relationship between operational skills and biliary complications after liver transplantation was observed. The potential risk factors about operative technique were summarized. Some preventive interventions for biliary complications were suggested.
RESULTS AND CONCLUSION: Biliary complication was diagnosed in 36 (7.6%) of 475 patients who underwent liver transplantation. They were nonanastomotic biliary stricture (n=19, 4.0%), anastomotic biliary stricture (n=7, 1.5%), biliary leakage (n=3, 0.6%), twisted common biliary duct (n=3, 0.6%), residual common duct stone (n=1, 0.2%), and neoformative common duct stone (n=3, 0.6%). There was no difference in the incidence of nonanastomotic biliary stricture among the three biliary anastomotic styles. The possibility of anastomotic biliary stricture in placing T-drainage tube group was lower than the other two groups according to clinical data. Nevertheless, there was no statistical difference between these three groups. Infusing UW into the liver from cranial mesenteric vein and douching the biliary duct immediately while taking the donor could decrease the incidence of biliary complication after liver transplantation (P=0.013 and P=0.018, OR=0.26 and OR=0.28), the later factor could also decrease the incidence of nonanastomotic biliary stricture (P=0.001, OR=0.09). Meanwhile, some operational skills also decrease the incidence of biliary complications, such as protecting the artery around the biliary duct, and elevating the liver when suturing the common biliary duct.

中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程

全文链接：

Key words: organ transplantation, liver transplantation, biliary tract, postoperative complications, bile ducts, gallstones

CLC Number:

R318

Song Ji-yong, Du Guo-sheng, Zhu Zhi-dong, Zheng De-hua, Feng Li-kui, Zhou Lin, Shi Bing-yi. Operative techniques in liver transplantation and biliary complications[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(27): 4299-4303.

Figures/Tables 3

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