Management of biliary complications after liver transplantation
Biliary tract complications after liver transplantation are common, and the evaluation of newer treatment options compared with standard surgical treatment is important. In 62 liver transplants performed in 55 adult patients, the biliary tract was reconstructed with choledochocholedochostomy (CC) in...
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| Veröffentlicht in: | The American journal of surgery 1992-05, Vol.163 (5), p.519-524 |
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| creator | Lopez, Richard R. Benner, Kent G. Ivancev, Krassi Keeffe, Emmet B. Deveney, Clifford W. Pinson, C.Wright |
| description | Biliary tract complications after liver transplantation are common, and the evaluation of newer treatment options compared with standard surgical treatment is important. In 62 liver transplants performed in 55 adult patients, the biliary tract was reconstructed with choledochocholedochostomy (CC) in 52 (84%) and Roux-en-Y choledochojejunostomy (RYCJ) in 10 (16%). Seventeen biliary tract complications occurred in 16 patients (29%). The incidence of complications was the same after CC and RYCJ. Eight complications (47%) occurred within the first month and nine (53%) thereafter. Only 6 of 17 (35%) biliary tract complications required operation. One patient died of a biliary tract complication. No other allografts were lost due to biliary tract complications.
Four patients transplanted at other centers were also treated, for a total of 21 biliary tract complications. Overall, there were nine bile leaks, eight bile duct strictures, two Roux loop hemorrhages, one choledocholithiasis, and one ampullary dyskinesia. Temporary or permanent stents were used successfully in seven of eight strictures. Five bile leaks were managed without operation. Nonsurgical management is appropriate for a selected majority of patients with late bile leaks, biliary tract strictures, or choledocholithiasis after liver transplantation. |
| doi_str_mv | 10.1016/0002-9610(92)90401-C |
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Four patients transplanted at other centers were also treated, for a total of 21 biliary tract complications. Overall, there were nine bile leaks, eight bile duct strictures, two Roux loop hemorrhages, one choledocholithiasis, and one ampullary dyskinesia. Temporary or permanent stents were used successfully in seven of eight strictures. Five bile leaks were managed without operation. Nonsurgical management is appropriate for a selected majority of patients with late bile leaks, biliary tract strictures, or choledocholithiasis after liver transplantation.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/0002-9610(92)90401-C</identifier><identifier>PMID: 1575311</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Bile ; Bile ducts ; Biliary tract ; Biliary Tract Diseases - diagnostic imaging ; Biliary Tract Diseases - etiology ; Biliary Tract Diseases - therapy ; Biological and medical sciences ; Cholangiography ; Choledochostomy - adverse effects ; Complications ; Dyskinesia ; Hemorrhage ; Humans ; Implants ; Liver ; Liver transplantation ; Liver Transplantation - adverse effects ; Liver transplants ; Liver, biliary tract, pancreas, portal circulation, spleen ; Medical sciences ; Stricture ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Transplantation ; Transplants ; Transplants & implants</subject><ispartof>The American journal of surgery, 1992-05, Vol.163 (5), p.519-524</ispartof><rights>1992</rights><rights>1992 INIST-CNRS</rights><rights>Copyright Elsevier Limited May 1992</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-768be70154255ee3a28b02f0b65000aaea7a036aa5b59713a2f85555817498d03</citedby><cites>FETCH-LOGICAL-c414t-768be70154255ee3a28b02f0b65000aaea7a036aa5b59713a2f85555817498d03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2847446285?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,3548,23928,23929,25138,27922,27923,45993,64383,64385,64387,72239</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5432591$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1575311$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lopez, Richard R.</creatorcontrib><creatorcontrib>Benner, Kent G.</creatorcontrib><creatorcontrib>Ivancev, Krassi</creatorcontrib><creatorcontrib>Keeffe, Emmet B.</creatorcontrib><creatorcontrib>Deveney, Clifford W.</creatorcontrib><creatorcontrib>Pinson, C.Wright</creatorcontrib><title>Management of biliary complications after liver transplantation</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Biliary tract complications after liver transplantation are common, and the evaluation of newer treatment options compared with standard surgical treatment is important. In 62 liver transplants performed in 55 adult patients, the biliary tract was reconstructed with choledochocholedochostomy (CC) in 52 (84%) and Roux-en-Y choledochojejunostomy (RYCJ) in 10 (16%). Seventeen biliary tract complications occurred in 16 patients (29%). The incidence of complications was the same after CC and RYCJ. Eight complications (47%) occurred within the first month and nine (53%) thereafter. Only 6 of 17 (35%) biliary tract complications required operation. One patient died of a biliary tract complication. No other allografts were lost due to biliary tract complications.
Four patients transplanted at other centers were also treated, for a total of 21 biliary tract complications. Overall, there were nine bile leaks, eight bile duct strictures, two Roux loop hemorrhages, one choledocholithiasis, and one ampullary dyskinesia. Temporary or permanent stents were used successfully in seven of eight strictures. Five bile leaks were managed without operation. Nonsurgical management is appropriate for a selected majority of patients with late bile leaks, biliary tract strictures, or choledocholithiasis after liver transplantation.</description><subject>Bile</subject><subject>Bile ducts</subject><subject>Biliary tract</subject><subject>Biliary Tract Diseases - diagnostic imaging</subject><subject>Biliary Tract Diseases - etiology</subject><subject>Biliary Tract Diseases - therapy</subject><subject>Biological and medical sciences</subject><subject>Cholangiography</subject><subject>Choledochostomy - adverse effects</subject><subject>Complications</subject><subject>Dyskinesia</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Implants</subject><subject>Liver</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver transplants</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Medical sciences</subject><subject>Stricture</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Transplantation</subject><subject>Transplants</subject><subject>Transplants & implants</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kF9LHDEUxYNUdGv9BgoDlVIfxuZmkknyYimL1YLSl_oc7mTvSGT-bJNZwW_fjLso9ME85BLO7x5ODmMnwC-AQ_2Ncy5KWwP_asW55ZJDudxjCzDalmBM9YEtXpFD9jGlx_wEkNUBOwClVQWwYN_vcMAH6mmYirEtmtAFjM-FH_t1FzxOYRxSge1EsejCU76niENadzhML-Intt9il-h4N4_Y_c-rP8ub8vb39a_lj9vSS5BTqWvTkOagpFCKqEJhGi5a3tQqh0Ik1MirGlE1ymrIemtUPga0tGbFqyP2Zeu7juPfDaXJ9SF56nIQGjfJaWFBZocMfv4PfBw3ccjZnDBSS1kLozIlt5SPY0qRWreOoc8_d8Dd3K6bq3Nzdc7mObfrlnntdGe-aXpavS1t68z62U7H5LFrc1c-pFdMyUooO2OXW4xyY0-Boks-0OBpFSL5ya3G8H6Of0Bik54</recordid><startdate>19920501</startdate><enddate>19920501</enddate><creator>Lopez, Richard R.</creator><creator>Benner, Kent G.</creator><creator>Ivancev, Krassi</creator><creator>Keeffe, Emmet B.</creator><creator>Deveney, Clifford W.</creator><creator>Pinson, C.Wright</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>19920501</creationdate><title>Management of biliary complications after liver transplantation</title><author>Lopez, Richard R. ; Benner, Kent G. ; Ivancev, Krassi ; Keeffe, Emmet B. ; Deveney, Clifford W. ; Pinson, C.Wright</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-768be70154255ee3a28b02f0b65000aaea7a036aa5b59713a2f85555817498d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Bile</topic><topic>Bile ducts</topic><topic>Biliary tract</topic><topic>Biliary Tract Diseases - diagnostic imaging</topic><topic>Biliary Tract Diseases - etiology</topic><topic>Biliary Tract Diseases - therapy</topic><topic>Biological and medical sciences</topic><topic>Cholangiography</topic><topic>Choledochostomy - adverse effects</topic><topic>Complications</topic><topic>Dyskinesia</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Implants</topic><topic>Liver</topic><topic>Liver transplantation</topic><topic>Liver Transplantation - adverse effects</topic><topic>Liver transplants</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Medical sciences</topic><topic>Stricture</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Transplantation</topic><topic>Transplants</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lopez, Richard R.</creatorcontrib><creatorcontrib>Benner, Kent G.</creatorcontrib><creatorcontrib>Ivancev, Krassi</creatorcontrib><creatorcontrib>Keeffe, Emmet B.</creatorcontrib><creatorcontrib>Deveney, Clifford W.</creatorcontrib><creatorcontrib>Pinson, C.Wright</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection (ProQuest Medical & Health Databases)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lopez, Richard R.</au><au>Benner, Kent G.</au><au>Ivancev, Krassi</au><au>Keeffe, Emmet B.</au><au>Deveney, Clifford W.</au><au>Pinson, C.Wright</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of biliary complications after liver transplantation</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>1992-05-01</date><risdate>1992</risdate><volume>163</volume><issue>5</issue><spage>519</spage><epage>524</epage><pages>519-524</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Biliary tract complications after liver transplantation are common, and the evaluation of newer treatment options compared with standard surgical treatment is important. In 62 liver transplants performed in 55 adult patients, the biliary tract was reconstructed with choledochocholedochostomy (CC) in 52 (84%) and Roux-en-Y choledochojejunostomy (RYCJ) in 10 (16%). Seventeen biliary tract complications occurred in 16 patients (29%). The incidence of complications was the same after CC and RYCJ. Eight complications (47%) occurred within the first month and nine (53%) thereafter. Only 6 of 17 (35%) biliary tract complications required operation. One patient died of a biliary tract complication. No other allografts were lost due to biliary tract complications.
Four patients transplanted at other centers were also treated, for a total of 21 biliary tract complications. Overall, there were nine bile leaks, eight bile duct strictures, two Roux loop hemorrhages, one choledocholithiasis, and one ampullary dyskinesia. Temporary or permanent stents were used successfully in seven of eight strictures. Five bile leaks were managed without operation. Nonsurgical management is appropriate for a selected majority of patients with late bile leaks, biliary tract strictures, or choledocholithiasis after liver transplantation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>1575311</pmid><doi>10.1016/0002-9610(92)90401-C</doi><tpages>6</tpages></addata></record> |
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| subjects | Bile Bile ducts Biliary tract Biliary Tract Diseases - diagnostic imaging Biliary Tract Diseases - etiology Biliary Tract Diseases - therapy Biological and medical sciences Cholangiography Choledochostomy - adverse effects Complications Dyskinesia Hemorrhage Humans Implants Liver Liver transplantation Liver Transplantation - adverse effects Liver transplants Liver, biliary tract, pancreas, portal circulation, spleen Medical sciences Stricture Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Transplantation Transplants Transplants & implants |
| title | Management of biliary complications after liver transplantation |
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