Biliary reconstruction using non‐penetrating, tissue everting clips versus conventional sewn biliary anastomosis in liver transplantation

Thomas, K. Tyson; Gorden, D. Lee; Chari, Ravi S.; Wright, J. Kelly; Feurer, Irene D.; Pinson, C. Wright

doi:10.1080/13651820510037620

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…In addition to RYHJ and either end‐to‐end or side‐to‐side CDC, other options of biliary anastomosis have been explored. Thomas et al showed that nonpenetrating, tissue‐everting clips for end‐to‐end CDC have rates of biliary complications equal to that of conventional hand‐sewn anastomoses 12. In addition, there are experimental reports indicating the use of fibrin glue for end‐to‐end CDC in dogs, which showed biliary complication rates of 30% 13…”

Section: Discussionmentioning

confidence: 99%

Continuous versus interrupted suture for end-to-end biliary anastomosis during liver transplantation gives equal results

et al. 2007

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Biliary complications following orthotopic liver transplantation have been reported in 10% to 30% of patients. Most surgeons perform an end-to-end choledochocholedochostomy with interrupted sutures for biliary reconstruction. The goal of this study was to compare biliary complications between interrupted suture (IS) and continuous suture (CS) techniques during liver transplantation in which an end-to-end choledochocholedochostomy over an internal biliary stent was performed. A retrospective cohort study of 100 consecutive liver transplants occurring between December 2003 and July 2005 was conducted. An end-to-end choledochocholedochostomy over an internal biliary stent was performed during liver transplantation. Data were analyzed using Kaplan-Meier methods, t tests, and chi-square tests of proportions. IS and CS techniques were used in 59 and 41 patients, respectively, for biliary reconstruction during liver transplantation. Mean follow-up time for the CS group was 17 Ϯ 8 months and 15 Ϯ 7 months for the IS group (P ϭ .21). The overall biliary complication rate was 15%. There was no difference in the proportion of leaks (CS ϭ 7.3%, IS ϭ 8.5%; P ϭ .83) or strictures (CS ϭ 9.8%, IS ϭ 5.1%; P ϭ .37) between groups. Kaplan-Meier event rates show no difference in leaks (P ϭ .79), strictures (P ϭ .41), graft survival (P ϭ .52), and patient survival (P ϭ .32) by anastomosis type. In conclusion, there was no difference in biliary complications, graft survival, or patient survival between the 2 groups. CS and IS techniques for biliary reconstruction during liver transplantation yield comparable outcomes. Liver Transpl 13: 234-238, 2007.

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Section: Discussionmentioning

confidence: 99%

Continuous versus interrupted suture for end-to-end biliary anastomosis during liver transplantation gives equal results

et al. 2007

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“…Another prospective randomized trial comparing interrupted and continuous suture in CDC, showed no differences between both suture types with respect to the incidence of leaks and strictures (166). A new technique of end‐to‐end CDC using vascular staples was proposed recently by Thomas (167). In this study tissue everting clips were compared with a conventional handsewn technique showing no differences in biliary complications between both techniques.…”

Section: Biliary Anastomosismentioning

confidence: 99%

The evolution of surgical techniques in clinical liver transplantation. A review

Polak

Peeters

Slooff

2009

Clinical Transplantation

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Currently, liver transplantation (LT) is an accepted method of treatment of end-stage liver disease, metabolic diseases with their primary defect in the liver and unresectable primary liver tumors. Surgical techniques in LT have evolved considerably over the past 40 yr. The developments have led to a safer procedure for the recipient reflected by continuously improving survival figures after LT. Also the new techniques offer the possibility of tailoring the operation to the needs and condition of the recipient as in partial grafting or in different revascularization techniques, or in techniques of biliary reconstructions. In addition, the new techniques such as split LT, domino transplantation and living donor LT have brought about an increase in the available grafts. In this review the evolution of surgical techniques in LT over the past 40 yr and their contribution to the current results are discussed.

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Management of the bile duct anastomosis and its complications after liver transplantation

Castaldo

Austin

Pinson

et al. 2007

Transplantation Reviews

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Biliary reconstruction using non‐penetrating, tissue everting clips versus conventional sewn biliary anastomosis in liver transplantation

Abstract: Biliary reconstruction can be performed clinically using NTEC as an alternative to conventional sewn biliary anastomoses with good results.

Cited by 3 publications

References 16 publications

Continuous versus interrupted suture for end-to-end biliary anastomosis during liver transplantation gives equal results

Continuous versus interrupted suture for end-to-end biliary anastomosis during liver transplantation gives equal results

The evolution of surgical techniques in clinical liver transplantation. A review

Management of the bile duct anastomosis and its complications after liver transplantation

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