Liver Transplantation as Definitive Treatment of Post-cholecystectomy Bile Duct Injury
Autor: | Ismael Dominguez-Rosado, Mario Vilatobá, Rafael P. Leal-Villalpando, Ignacio García-Juárez, Miguel Angel Mercado, Rodrigo Figueroa-Méndez, Mariana Chávez-Villa, Rodrigo Cruz-Martínez |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
business.industry Bile duct medicine.medical_treatment Bile Duct Diseases Liver transplantation Liver Transplantation Surgery medicine.anatomical_structure Cholecystectomy Laparoscopic Quality of Life medicine Humans Cholecystectomy Bile Ducts Prospective Studies business Retrospective Studies Volume (compression) |
Zdroj: | Annals of Surgery. 275:e729-e732 |
ISSN: | 1528-1140 0003-4932 |
DOI: | 10.1097/sla.0000000000005245 |
Popis: | To analyze the perioperative and long-term outcomes of patients undergoing LT due to BDI in a tertiary care center.BDI is associated with significant morbidity and long-term impact on quality of life. LT represents the only possibility of a cure in patients with BDI who develop SBC.Retrospective cohort study from a prospective LT database. Between 2008 and 2019, patients with SBC due to BDI after cholecystectomy and requiring LT were identified. Perioperative and long-term outcomes were analyzed.Among 354 LT, 12 patients underwent LT to treat post-cholecystectomy BDI and accounted for 3.4% of all LT. The median time from BDI to SBC diagnosis was 9.3 years (2.4-14). The mean time from SBC to inclusion on the waitlist was 2.4years (± 2.2). Postoperative complications occurred in 11 patients (91.6%); mainly infectious (9/12 patients, 75%), followed by renal complications (4/12 patients, 33.3%). Only 2 patients developed major complications, which were the patients who died, resulting in a 90-day mortality of 16.7%. After a mean follow-up of 40.3 months (± 42.2) survival at 1, 3, and 5 years was 83%.Although BDI is an unusual indication for LT worldwide, it accounted for 3.4% of all LT in our center. Although postoperative mortality remains high, LT is the only possibility of a cure, with acceptable long-term outcomes. Early referral to a tertiary care center is essential to avoid long-term complications of BDI, such as SBC. |
Databáze: | OpenAIRE |
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