BACKGROUND: Bile duct injury (BDI) is a severe complication that may arise during the surgical treatment of a benign disease. A significant proportion of cases develop end-stage liver disease and a liver transplant is required. The aim of this study was to analyze the indications and results of liver transplantation as treatment for BDI. METHODS: Between January 1988 and May 2007, 20 patients with end-stage liver disease secondary to BDI were included on the liver transplant waiting list. Retrospective charts were analyzed and survival was estimated by the Kaplan-Meier test. RESULTS: Four patients died while on the waiting list and 16 received a transplant. Injury to the bile duct occurred during a cholecystectomy in 13 of 16 patients, with the main cause of the lesion being duct division in six patients and resection in four. All patients had received some surgical treatment (median = 2 procedures) before being considered for a transplant. The liver transplant came from a cadaveric donor for all patients and the median time between BDI and liver transplant was 60 months. Two patients died in the postoperative period and nine had complications. Three patients died in the late postoperative period. Median follow-up was 62 (range = 24-152) months. One-, three-, and five-year survival rates were 81, 75, and 75%, respectively. CONCLUSION: Complex bile duct injuries and bile duct injuries with previous repair attempts can result in end-stage liver disease. In these cases, liver transplantation provides long-term survival.
BACKGROUND:Bile duct injury (BDI) is a severe complication that may arise during the surgical treatment of a benign disease. A significant proportion of cases develop end-stage liver disease and a liver transplant is required. The aim of this study was to analyze the indications and results of liver transplantation as treatment for BDI. METHODS: Between January 1988 and May 2007, 20 patients with end-stage liver disease secondary to BDI were included on the liver transplant waiting list. Retrospective charts were analyzed and survival was estimated by the Kaplan-Meier test. RESULTS: Four patients died while on the waiting list and 16 received a transplant. Injury to the bile duct occurred during a cholecystectomy in 13 of 16 patients, with the main cause of the lesion being duct division in six patients and resection in four. All patients had received some surgical treatment (median = 2 procedures) before being considered for a transplant. The liver transplant came from a cadaveric donor for all patients and the median time between BDI and liver transplant was 60 months. Two patients died in the postoperative period and nine had complications. Three patients died in the late postoperative period. Median follow-up was 62 (range = 24-152) months. One-, three-, and five-year survival rates were 81, 75, and 75%, respectively. CONCLUSION: Complex bile duct injuries and bile duct injuries with previous repair attempts can result in end-stage liver disease. In these cases, liver transplantation provides long-term survival.
Authors: Genevieve B Melton; Keith D Lillemoe; John L Cameron; Patricia A Sauter; JoAnn Coleman; Charles J Yeo Journal: Ann Surg Date: 2002-06 Impact factor: 12.969
Authors: Joseph F Buell; David C Cronin; Brian Funaki; Alan Koffron; Atsushi Yoshida; Agnes Lo; Jeffery Leef; J Michael Millis Journal: Arch Surg Date: 2002-06
Authors: Ernest L Sink; Michael Leunig; Ira Zaltz; Jennifer Claire Gilbert; John Clohisy Journal: Clin Orthop Relat Res Date: 2012-04-19 Impact factor: 4.176
Authors: Nicolaj M Stilling; Claus Fristrup; André Wettergren; Arnas Ugianskis; Jacob Nygaard; Kathrine Holte; Linda Bardram; Mogens Sall; Michael B Mortensen Journal: HPB (Oxford) Date: 2015-01-12 Impact factor: 3.647
Authors: Richard Iorio; Craig J Della Valle; William L Healy; Keith R Berend; Fred D Cushner; David F Dalury; Jess H Lonner Journal: Clin Orthop Relat Res Date: 2014-01 Impact factor: 4.176
Authors: L McCormack; A Gadano; J Lendoire; O Imventarza; O Andriani; O Gil; L Toselli; L Bisigniano; E de Santibañes Journal: HPB (Oxford) Date: 2010-09 Impact factor: 3.647
Authors: Victoria Ardiles; Lucas McCormack; Emilio Quiñonez; Nicolás Goldaracena; Juan Mattera; Juan Pekolj; Miguel Ciardullo; Eduardo de Santibañes Journal: HPB (Oxford) Date: 2011-06-24 Impact factor: 3.647
Authors: Russell C Kirks; T E Barnes; Patrick D Lorimer; Allyson Cochran; Imran Siddiqui; John B Martinie; Erin H Baker; David A Iannitti; Dionisios Vrochides Journal: HPB (Oxford) Date: 2016-07-25 Impact factor: 3.647