| Autor: |
Jeffrey, Gary P., Brind, Alison M., Ormonde, Donald G., Frazer, Christopher K., Ferguson, John, Bell, Roger, Kierath, Anthony, Reed, William D., House, Anthony K. |
| Předmět: |
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| Zdroj: |
Australian & New Zealand Journal of Surgery; Oct99, Vol. 69 Issue 10, p717, 6p |
| Abstrakt: |
Background: A review of biliary tract complications was performed in 32 patients who underwent liver transplantation by the Western Australian Liver Transplantation Service during a 2-year period. Methods: A review was made of patient data collected prospectively, and confirmed by retrospective casenote review. Results: A total of 30 patients (31 grafts) survived more than 2 days after transplantation, and of these 28 had an end-to-end biliary anastomosis. Analysis of these 28 patients found that eight of 17 patients with T-tubes had complications: three leaks at T-tube removal; two strictures and leaks; and three strictures. Six of 11 patients without a T-tube had complications: one leak; three strictures and leaks; and two strictures. Predisposing factors were present in eight of the 14 patients with biliary tract complications: hepatic artery stenosis in three; and one each with hepatic artery thrombosis; biliary calculi; donor-recipient bile duct mismatch; severe cellular rejection; and prolonged postoperative hypotension. Acute rejection, steroid-resistant rejection and cytomegalovirus infection were all significantly more common in those patients with biliary tract complications compared with those without. There was no difference in cold ischaemic time or donor age. Twelve of the 14 patients with biliary complications required endoscopic stenting with or without balloon dilation, and eight patients required radiological percutaneous drainage of bile collections. Only one patient required biliary reconstruction and two patients required re-transplantation. One patient died of uncontrolled infection. Of three patients who underwent choledochojejunostomy, biliary leak developed in two... [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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