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Biliary tract complications in human orthotopic liver transplantation

Lerut, J and Gordon, RD and Iwatsuki, S and Esquivel, CO and Todo, S and Tzakis, A and Starzl, TE (1987) Biliary tract complications in human orthotopic liver transplantation. Transplantation, 43 (1). 47 - 50. ISSN 0041-1337

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The results of 393 consecutive orthotopic liver transplants in 313 patients were reviewed to determine the incidence of primary biliary tract complications. There were 52 biliary tract complications in 393 grafts (13.2%), and 5 directly related deaths. Choledochojejunostomy over an internal stent to a Roux-en-Y limb of proximal jejunum (RYCJ-S) was the most frequently used technique (175 cases) and the most successful with only 9 technical failures (5.2%). Choledochocholedochostomy over a T tube (CC-T) was used in 159 cases and was successful in all but 20 cases (12.6%). Other methods of reconstruction were associated with high failure rates or technical complexity that do not justify their use. Biliary leak and obstruction were the most common complications. Leakage after CC-T at the T tube exit site was usually directly repaired, but anastomotic leakage required conversion to RYCJ-S. Obstruction may be relieved by percutaneous balloon dilatation but definitive treatment also usually required conversion to RYCJ-S. The most common complication after RYCJ-S is functional obstruction by a retained stent, which has a low morbidity but may necessitate surgical removal. Anastomotic leaks, which occurred in 2 cases, were successfully managed by revision of the choledochojejunostomy. © Williams & Wilkins 1987. All Rights Reserved.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Lerut, J
Gordon, RD
Iwatsuki, S
Esquivel, CO
Todo, S
Tzakis, A
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1987
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 43
Number: 1
Page Range: 47 - 50
DOI or Unique Handle: 10.1097/00007890-198701000-00011
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062119130, Starzl CV No. 718
Date Deposited: 08 Apr 2010 17:12
Last Modified: 02 Feb 2019 13:56


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