Early Biliary Complications after Orthotopic Liver Transplantation – Non-Randomised Comparison of 3 Methods of Biliary Tract Drainage
1Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
2Medical University of Warsaw, Warsaw, Poland
3I Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland.
Meeting: 2018 American Transplant Congress
Abstract number: A255
Keywords: Bile duct, Length of stay, Surgical complications
Session Information
Session Name: Poster Session A: Liver Retransplantation and Other Complications
Session Type: Poster Session
Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Background
Biliary tract complications (BTC) are still relatively common and complex problem following orthotopic liver transplantation (OLT). The aim of this nonrandomized study was to evaluate the incidence of early BTC in liver transplant recipients depends off different types of biliary drainage.
Patients and methods
From January 2010 to October 2017 335 OLTs were performed at our Institution. Patients who died (no relation to biliary complications) or lost graft were excluded. 309 OLT recipients with duct-to-duct anastomosis (only) were incorporated into the study. In 118 recipients external drainage (ED) of biliary duct with straight silicone drain (Levin type drain) was used, 167 patients had no biliary drain (ND) and remaining 24 had intraductal stent implanted during transplantation (IS).
Results
The overall incidence of early biliary complication was comparable in each group: ED – 30% vs. ND – 20% vs. IS – 25% (P=NS). Temporary biliary leakage (no surgical or endoscopic intervention required) occurred most often (P=0,01) in ED group (12.7%) mostly following drain removal (3,6%; 4% in ND and IS respectively). Surgical intervention or ERCP was necessary in 13% of ND group, 1,7% in ED group, and 8% in IS group (P=0,003). Incidence of cholangitis (11% in ED group, 6% in ND group and 8% in IS group) and biliary strictures (3,4%, 1,2%, and 0% respectively) were similar.
Hospital stay was longest in ED group (respectively, 35±18 vs 28±13 ND group, and 31±14 days IS group, p<0.001).
Conclusions
Had biliary complications occurred, they were more severe and required more endoscopic interventions in ND group. Nevertheless, hospital stay was shortest in this group. Minor complications were most common after external drain removal.
CITATION INFORMATION: Jóźwik A., Kosieradzki M., Łągiewska B., Lisik W., Karpeta E., Bednarek J., Zaborska M., Trzebicki J., Pacholczyk M. Early Biliary Complications after Orthotopic Liver Transplantation – Non-Randomised Comparison of 3 Methods of Biliary Tract Drainage Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Jóźwik A, Kosieradzki M, Łągiewska B, Lisik W, Karpeta E, Bednarek J, Zaborska M, Trzebicki J, Pacholczyk M. Early Biliary Complications after Orthotopic Liver Transplantation – Non-Randomised Comparison of 3 Methods of Biliary Tract Drainage [abstract]. https://atcmeetingabstracts.com/abstract/early-biliary-complications-after-orthotopic-liver-transplantation-non-randomised-comparison-of-3-methods-of-biliary-tract-drainage/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress