Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Biliary complications have been known as “Achilles Heel” of orthotropic liver transplantation (OLT) with high morbidity and mortality. Intra-luminal plastic biliary stents replacing T-tubes for duct-to-duct biliary anastomosis has reported to reduce post-transplant biliary complications but data is scarce. Our aim was to study clinical outcome with use of internal biliary stent for biliary reconstruction during liver transplant.
*Methods: We conducted a single center retrospective analysis over consecutive 5-year period (2012 – 2017). Patient charts were followed up prospectively for 1 year after liver transplantation to assess the biliary leaks/strictures, need for repeat ERCPs with associated complications and overall graft and patient survival. Patient were grouped into 2 cohorts (intraluminal plastic biliary stent group and no stent group)
*Results: A total of 58 deceased donor liver transplantations were included for study. Primary indication for liver transplantation was Hepatitis C (34.5%), Laennec cirrhosis (34.5%), NASH cirrhosis (22.4%), HCC (12.1%) and other (24.1%). There were 28 patients (48.3%) in each cohort who underwent direct duct-to-duct biliary anastomosis vs biliary anastomosis over intra-luminal plastic biliary stent (5 to 8fr). 2 patients (3.4%) underwent biliary anastomosis over T-tube which were excluded from final analysis. Overall biliary complications rate was 22.4 %. Bile leak was seen in two patients, one in each group. Biliary strictures were detected with greater frequency in biliary stent group vs no stent group (7 vs 4, p value > 0.05.) though the difference was not statistically significant. No patient in either group had graft loss or required re-operation.
*Conclusions: Our results indicate that there is no particular difference in biliary complications between biliary reconstruction with or without intraluminal plastic biliary stent. Biliary reconstruction over intraluminal plastic stent is useful particularly with mismatch between donor and recipient bile duct diameters. Biliary strictures may get reported non-significantly higher during ERCP for stent removal in stent group which can increase subsequent endoscopic procedures.
To cite this abstract in AMA style:Samant H, Patel K, Manatsathit W, Singh N, Amiri HS, Zibari G. Bile Duct Anastomosis over Intraluminal Plastic Biliary Stent in Liver Transplant: Clinical Outcome [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/bile-duct-anastomosis-over-intraluminal-plastic-biliary-stent-in-liver-transplant-clinical-outcome/. Accessed November 17, 2019.
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