Delayed biliary duct obstruction after orthotopic liver transplantation
| Autor: | Martineau, G., Porter, K. A., Gorman, J., Launois, B., Schroter, G. T., Palmer, W., Putnam, C. W., Groth, C. G., Halgrimson, C. G., Penn, I., Starzl, T. E. |
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| Jazyk: | angličtina |
| Rok vydání: | 1972 |
| Předmět: |
Cholestasis
Adolescent Fever Cholangitis Clostridium perfringens Duodenum Leukocytosis Biliary Tract Diseases Cystic Duct Enterobacter Infant Bilirubin Article Liver Transplantation Postoperative Complications Klebsiella Cytomegalovirus Infections Escherichia coli Humans Transplantation Homologous Cholecystectomy Child |
| Popis: | After orthotopic liver transplantation and biliary reconstruction by cholecystoduodenostomy, four of 40 patients developed delayed obstruction of the cystic duct. The recipients had the clinical syndrome of fulminating cholangitis with jaundice, fever, leukocytosis, toxemia, and bacteremia. All four patients died; of the four, two patients died despite late reoperation and re-establishment of bile drainage by choledochoenterostomy. In all four cases, a factor contributing to the biliary obstruction may have been infection of the extrahepatic biliary ducts with or without ulceration, and in three of the livers, there was evidence of infection of the ducts with CMV. If cholecystoduodenostomy is used in future cases, prompt re-exploration and conversion to choledochoenterostomy should be considered if the diagnosis of duct obstruction, cholangitis, and persistent bacteremia are made. |
| Databáze: | OpenAIRE |
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