BACKGROUND: Biliary complications following liver transplantation result in major morbidity. We undertook a 10-year audit of the incidence, management and outcomes of post-transplant biliary complications at the New Zealand Liver Transplant Unit. METHODS: Prospectively collected data on 348 consecutive liver transplants performed between February 1998 and October 2008 were reviewed. The minimum follow-up was 6 months. RESULTS: A total of 309 adult and 39 paediatric transplants were performed over the study period. Of these, 296 (85%) were whole liver grafts and 52 (15%) were partial liver grafts (24 split-liver, eight reduced-size and 20 live-donor grafts). There were 80 biliary complications, which included 63 (18%) strictures and 17 (5%) bile leaks. Partial graft, a paediatric recipient and a Roux-en-Y biliary anastomosis were independent predictors of biliary strictures. Twenty-five (40%) strictures were successfully managed non-operatively and 38 (60%) required surgery (31 biliary reconstructions, three segmental resections and four retransplants). Seven (41%) bile leaks required surgical revision and 10 (59%) were managed non-operatively. There was no mortality related directly to biliary complications. CONCLUSIONS: Biliary complications affected one in five transplant recipients. Paediatric status, partial graft and Roux-en-Y anastomosis were independently associated with the occurrence of biliary strictures. Over half of the affected patients required surgical revision, but no mortality resulted from biliary complications.
BACKGROUND: Biliary complications following liver transplantation result in major morbidity. We undertook a 10-year audit of the incidence, management and outcomes of post-transplant biliary complications at the New Zealand Liver Transplant Unit. METHODS: Prospectively collected data on 348 consecutive liver transplants performed between February 1998 and October 2008 were reviewed. The minimum follow-up was 6 months. RESULTS: A total of 309 adult and 39 paediatric transplants were performed over the study period. Of these, 296 (85%) were whole liver grafts and 52 (15%) were partial liver grafts (24 split-liver, eight reduced-size and 20 live-donor grafts). There were 80 biliary complications, which included 63 (18%) strictures and 17 (5%) bile leaks. Partial graft, a paediatric recipient and a Roux-en-Y biliary anastomosis were independent predictors of biliary strictures. Twenty-five (40%) strictures were successfully managed non-operatively and 38 (60%) required surgery (31 biliary reconstructions, three segmental resections and four retransplants). Seven (41%) bile leaks required surgical revision and 10 (59%) were managed non-operatively. There was no mortality related directly to biliary complications. CONCLUSIONS: Biliary complications affected one in five transplant recipients. Paediatric status, partial graft and Roux-en-Y anastomosis were independently associated with the occurrence of biliary strictures. Over half of the affected patients required surgical revision, but no mortality resulted from biliary complications.
Authors: R W Osorio; C E Freise; P G Stock; J R Lake; J M Laberge; R L Gordon; E J Ring; N L Ascher; J P Roberts Journal: Transplantation Date: 1993-05 Impact factor: 4.939
Authors: L Sanchez-Urdazpal; G J Gores; E M Ward; T P Maus; H E Wahlstrom; S B Moore; R H Wiesner; R A Krom Journal: Hepatology Date: 1992-07 Impact factor: 17.425
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Authors: A B Zajko; W L Campbell; G A Logsdon; K M Bron; A Tzakis; C O Esquivel; T E Starzl Journal: AJR Am J Roentgenol Date: 1987-09 Impact factor: 3.959
Authors: L Sanchez-Urdazpal; G J Gores; E M Ward; T P Maus; E G Buckel; J L Steers; R H Wiesner; R A Krom Journal: Hepatology Date: 1993-04 Impact factor: 17.425
Authors: J O Colonna; A Shaked; A S Gomes; S D Colquhoun; O Jurim; S V McDiarmid; J M Millis; L I Goldstein; R W Busuttil Journal: Ann Surg Date: 1992-09 Impact factor: 12.969
Authors: Emad Hamdy Gad; Eslam Ayoup; Amr M Aziz; Tarek Ibrahim; Mostafa Elhelbawy; Mohammed Al-Sayed Abd-Elsamee; Ahmed Nabil Sallam Journal: Ann Med Surg (Lond) Date: 2022-04-14
Authors: Arun P Palanisamy; D J Taber; A G Sutter; S N Nadig; J E Dowden; J W McGillicuddy; P K Baliga; K D Chavin Journal: J Gastrointest Surg Date: 2014-10-16 Impact factor: 3.452