Routine use of the T tube in the biliary reconstruction of liver transplantation: is it worthwhile?

Grande, Luís; Pérez-Castilla, Alberto; Matus, D; Rodríguez-Montalvo, Carlos; Rimola, A.; Navasa, Miguel; García-Valdecasas, J.C.; Visa, Josep

doi:10.1016/s0041-1345(99)00398-x

Cited by 23 publications

(16 citation statements)

References 7 publications

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“…At our center, duct-to-duct anastomosis is typically performed over a drainage catheter, used to monitor bile flow and color and to perform cholangiography. Although use of a biliary stent is thought to increase the risk of infection in deceased donor whole liver transplantation [15], several authors [16,17] have demonstrated that it may be of value in partial liver transplantation because it reduces the risk of leaks from both anastomoses and cut surfaces.…”

Section: Discussionmentioning

confidence: 99%

Infection Complications and Pattern of Bacterial Resistance in Living-Donor Liver Transplantation: A Multicenter Epidemiologic Study in Egypt

Mukhtar

Abdelaal

Hussein

et al. 2014

Transplantation Proceedings

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Section: Discussionmentioning

confidence: 99%

Infection Complications and Pattern of Bacterial Resistance in Living-Donor Liver Transplantation: A Multicenter Epidemiologic Study in Egypt

Mukhtar

Abdelaal

Hussein

et al. 2014

Transplantation Proceedings

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“…Complications were reported in up to 33% of all T-tube removals. [13][14][15][16] The relative risk of the use of stent or T-tube splinting was calculated to be 2.1 in a small cohort of patients. 17 Early T-tube insertion site leaks may reflect relative downstream obstruction or Biliary Complications After Liver Transplantation papillary dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Biliary Reconstruction Using a Side-to-Side Choledochocholedochostomy With or Without T-Tube in Deceased Donor Liver Transplantation

et al. 2009

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This study is a large prospective randomized trial to assess biliary complications that occur following liver transplantation, after anatomizing the bile duct with or without T-tubes. A significant increased rate of complications in the group without T-tube insertion was observed. In summary, our results indicate that the usage of T-tubes is safe and an excellent tool for the quality control of biliary anastomoses.

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“…Biliary drains, however, may increase complication rates by frequently observed leaks following bile drain removal, its dislodgement, cholangitis and biliary obstruction [5, 8, 90, 92, 93]. The incidence of biliary drain-related biliary complications range between 10 and 22%, with bile leak after bile drain removal occurring in 5–15% of patients [82, 90,94,95,96]. This is due to inadequate development of a fibrous fistulous tract along the course of the drain as a result of impaired fibrogenesis under immunosuppression with the use of steroids [97].…”

Section: Use Of T-tube and Biliary Complicationsmentioning

confidence: 99%

Biliary Tract Complications after Liver Transplantation: A Review

Wójcicki¹,

Milkiewicz²,

2008

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Biliary complications continue to be a major cause of morbidity in liver transplant recipients with an incidence of 10–30% following whole-organ transplantation and a mortality rate of up to 10%. Biliary leaks and strictures are most common but sphincter of Oddi dysfunction, hemobilia, and biliary obstruction are also observed. Biliary complications may be related to various factors such as hepatic artery patency, preservation injury, cytomegalovirus infection, chronic ductopenic rejection, ABO incompatibility, and technical reasons. The latter include imperfect anastomosis, T-tube-related complications and the use of partial liver grafts when cut surface biliary leaks or inadvertent bile duct injuries may occur during parenchymal division. The usage of a T-tube for duct-to-duct anastomosis in whole-organ liver transplantation remains controversial, mainly because of the high rates of T-tube-related complications observed in many series. In this article we review the etiology, as well as the main types of biliary complications according to the technique of biliary reconstruction and liver transplant procedure performed. Their management is also discussed with interventional radiology and endoscopic techniques emerging as the preferred treatment option, obviating the need for surgery in a selected majority of patients.

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Routine use of the T tube in the biliary reconstruction of liver transplantation: is it worthwhile?

Cited by 23 publications

References 7 publications

Infection Complications and Pattern of Bacterial Resistance in Living-Donor Liver Transplantation: A Multicenter Epidemiologic Study in Egypt

Infection Complications and Pattern of Bacterial Resistance in Living-Donor Liver Transplantation: A Multicenter Epidemiologic Study in Egypt

Biliary Reconstruction Using a Side-to-Side Choledochocholedochostomy With or Without T-Tube in Deceased Donor Liver Transplantation

Biliary Tract Complications after Liver Transplantation: A Review

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