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Analysis of surgical complications after 397 hepatic transplantations

Lebeau, G and Yanaga, K and Marsh, JW and Tzakis, AG and Makowka, L and Gordon, RD and Todo, S and Stieber, AC and Iwatsuki, S and Starzl, TE (1990) Analysis of surgical complications after 397 hepatic transplantations. Surgery Gynecology and Obstetrics, 170 (4). 317 - 322. ISSN 0039-6087

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Abstract

The results of 397 consecutive orthotopic hepatic transplantations in 333 recipients were reviewed. One or more surgical complications developed in 172 of 323 patients (55 per cent), excluding ten intraoperative deaths. The six month mortality rate among the patients with surgical complications (55 of 172; 32 per cent) was statistically higher than that among patients without such complications (16 of 151; 11 per cent) (p < 0.001; chi-square, 58.36). Surgical complications including exploratory laparotomy for bleeding or infection in 74 (22 per cent), reconstruction of the bile duct for biliary obstruction or leakage in 55 (17 per cent), external biliary drainage for biliary leakage in four (1 per cent), tracheostomy in 80 (24 per cent), thoracotomy in 12 (4 per cent) and splenectomy in seven (2 per cent). The incidence of biliary obstruction (16 per cent mortality rate) and leakage (48 per cent mortality rate) was 18 per cent (34 of 193) and 2 per cent (four of 193) each after choledochocholedochostomy, which was 3 per cent (five of 187) and 9 per cent (17 of 187) each choledochojejunostomy. Biliary obstruction (16 per cent mortality rate) was more common after choledochocholedochostomy (p < 0.005; chi-square, 23.01), whereas the incidence of more serious biliary leakage (48 per cent mortality rate) was higher after choledochojejunostomy (p < 0.005; chi-square, 8.97). It is concluded that orthotopic hepatic transplantation remains an unforgiving extensive surgical procedure, in which choledochocholedochostomy remains the first-choice reconstruction of the biliary tract because of its lower mortality.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Lebeau, G
Yanaga, K
Marsh, JW
Tzakis, AG
Makowka, L
Gordon, RD
Todo, S
Stieber, AC
Iwatsuki, S
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1990
Date Type: Publication
Journal or Publication Title: Surgery Gynecology and Obstetrics
Volume: 170
Number: 4
Page Range: 317 - 322
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0039-6087
Other ID: uls-drl:31735062110956, Starzl CV No. 1053
Date Deposited: 08 Apr 2010 17:18
Last Modified: 05 Feb 2019 11:55
URI: http://d-scholarship.pitt.edu/id/eprint/4439

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