Biliary complications in donors for living donor liver transplantation
| Autor: | Shinji Uemoto, Kazunori Hasegawa, Junichi Yamauchi, Yoshihisa Tsuji, Shujiro Yazumi, Seiji Shio, Shinsuke Tada, Kohei Ogawa, Hiroshi Ida, Masaya Kida, Tsutomu Chiba |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Ileus Adolescent medicine.medical_treatment Biliary Tract Diseases Liver transplantation Gastroenterology Cohort Studies Internal medicine medicine Living Donors Hepatectomy Humans Aged Retrospective Studies Hepatology medicine.diagnostic_test business.industry Incidence (epidemiology) Retrospective cohort study Endoscopy Middle Aged medicine.disease Surgery Liver Transplantation Transplantation Treatment Outcome Biliary tract Tissue and Organ Harvesting Female business Complication |
| Zdroj: | The American journal of gastroenterology. 103(6) |
| ISSN: | 1572-0241 |
| Popis: | OBJECTIVES: With the increasing number of living donor liver transplantations, biliary complications in donorshave emerged as a major postoperative problem. The aim of the present study was to characterizethe features of the biliary complications that occur in donors.METHODS: The study subjects comprised 731 consecutive patients who donated liver grafts (434 right-lobe and297 left-lobe grafts) for transplantation at Kyoto University Hospital from July 1999 to December2006. Donors whose biliary complications could not be cured by conservative therapy were referredfor endoscopic treatment.RESULTS: Postoperative biliary complications occurred in 55 (7.5%) donors. Initially, 48 of these 55 donorshad biliary leakage and 7 had biliary stricture. Subsequently, 5 of 48 donors with leakage developedbiliary stricture. The respective incidences of biliary leakage and overall biliary complications weresignificantly higher among donors of right-lobe grafts (9.9% and 11.1%) than among donors ofleft-lobe grafts (1.7% and 2.4%). Among 55 donors with biliary complications, 24 were cured byconservative therapy, and 1 was converted to surgical repair due to ileus. Endoscopic treatment wassuccessful in 24 of 30 (80%) donors treated by endoscopic retrograde cholangiography, while theremaining 6 (20%) patients underwent surgery due to difficulties with cannulation (N = 2), excessivebiliary leakage (N = 2), or complete biliary obstruction (N = 2).CONCLUSIONS: Donors of right-lobe grafts have a significantly higher incidence of biliary complications than donorsof left-lobe grafts. When conservative therapy fails, endoscopic treatment is effective for thesecomplications, and should be attempted as the first-line therapy before surgical repair.(Am J Gastroenterol 2008;103:1393–1398) |
| Databáze: | OpenAIRE |
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