Biliary complications after liver transplantation

Chien-Hua Lin, Teng-Wei Chen, Jiun-Chou Shao, Huan-Fa Hsieh, Heng-Cheng Chu, Jyh-Cherng Yu, Yao-Chi Liu, Chung-Bao Hsieh

Research output: Contribution to journalArticle

Abstract

Background: The purpose of this study was to report the morbidity and mortality of patients who undergo liver transplantation with or without T-tube implantation after choledochocholedochostomy as well as to discuss management of bile duct complications. Patients and Methods: From August 2001 to November 2005, a retrospective review of 94 orthotopic liver transplantations was conducted. 43 patients underwent choledochocholedochostomy with T-tube implantation (group A); 45 patients underwent choledochocholedochostomy without T-tube implantation (group B). Three patients who underwent living donor liver transplantation and 3 choledochojejunostomy patients were excluded. Results: Between the two groups, there were no significant differences in clinical characteristics, including sex, age, indication of liver transplantation (hepatitis B virus, hepatitis C virus, alcoholic liver cirrhosis, or hepatocellular carcinoma), Child-Pugh classification, preoperative laboratory data, and operative, macroscopic and microscopic findings. Additionally, there were no significant differences in bile duct complications and overall survival rate. Of these 88 patients with orthotopic liver transplantation, 11 (12.5%) developed biliary complications (10 male, 1 female). Seven patients had anastomostic stricture and underwent endoscopic retrograde cholangiopancreatography (ERCP) with stent implantation. In 5 of these patients ERCP and stent implantation failed, and surgery was done with successful results. Conclusions: Whether or not stent implantation is done during choledochocholedochostomy after OLT has no impact on the frequency of biliary complications or survival time. The biliary complications after liver transplantation can be managed by ERCP with stent implantation. If ERCP fails, surgical intervention should be considered immediately. © 2006 S. Karger GmbH.
Original languageEnglish
Pages (from-to)73-78
Number of pages6
JournalChirurgische Gastroenterologie Interdisziplinar
Volume22
Issue number2
DOIs
Publication statusPublished - 2006
Externally publishedYes

Fingerprint

Liver Transplantation
Endoscopic Retrograde Cholangiopancreatography
Stents
Bile Ducts
Choledochostomy
Alcoholic Liver Cirrhosis
Living Donors
Hepatitis B virus
Sex Characteristics
Hepacivirus
Hepatocellular Carcinoma
Pathologic Constriction
Survival Rate
Morbidity
Survival
Mortality

Keywords

  • Biliary complication
  • Choledochocholedochostomy
  • Liver transplantation
  • T-tube
  • adult
  • alcohol liver cirrhosis
  • article
  • bile duct obstruction
  • biliary tract disease
  • choledochojejunostomy
  • controlled study
  • disease classification
  • endoscopic retrograde cholangiopancreatography
  • female
  • hepatitis B
  • Hepatitis B virus
  • hepatitis C
  • Hepatitis C virus
  • human
  • implantation
  • liver cell carcinoma
  • liver transplantation
  • major clinical study
  • male
  • microscopy
  • preoperative period
  • sex difference
  • statistical significance
  • stent
  • surgical technique
  • survival rate
  • T tube
  • treatment failure
  • treatment indication
  • treatment outcome

Cite this

Lin, C-H., Chen, T-W., Shao, J-C., Hsieh, H-F., Chu, H-C., Yu, J-C., ... Hsieh, C-B. (2006). Biliary complications after liver transplantation. Chirurgische Gastroenterologie Interdisziplinar, 22(2), 73-78. https://doi.org/10.1159/000093318

Biliary complications after liver transplantation. / Lin, Chien-Hua; Chen, Teng-Wei; Shao, Jiun-Chou; Hsieh, Huan-Fa; Chu, Heng-Cheng; Yu, Jyh-Cherng; Liu, Yao-Chi; Hsieh, Chung-Bao.

In: Chirurgische Gastroenterologie Interdisziplinar, Vol. 22, No. 2, 2006, p. 73-78.

Research output: Contribution to journalArticle

Lin, C-H, Chen, T-W, Shao, J-C, Hsieh, H-F, Chu, H-C, Yu, J-C, Liu, Y-C & Hsieh, C-B 2006, 'Biliary complications after liver transplantation', Chirurgische Gastroenterologie Interdisziplinar, vol. 22, no. 2, pp. 73-78. https://doi.org/10.1159/000093318
Lin, Chien-Hua ; Chen, Teng-Wei ; Shao, Jiun-Chou ; Hsieh, Huan-Fa ; Chu, Heng-Cheng ; Yu, Jyh-Cherng ; Liu, Yao-Chi ; Hsieh, Chung-Bao. / Biliary complications after liver transplantation. In: Chirurgische Gastroenterologie Interdisziplinar. 2006 ; Vol. 22, No. 2. pp. 73-78.
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title = "Biliary complications after liver transplantation",
abstract = "Background: The purpose of this study was to report the morbidity and mortality of patients who undergo liver transplantation with or without T-tube implantation after choledochocholedochostomy as well as to discuss management of bile duct complications. Patients and Methods: From August 2001 to November 2005, a retrospective review of 94 orthotopic liver transplantations was conducted. 43 patients underwent choledochocholedochostomy with T-tube implantation (group A); 45 patients underwent choledochocholedochostomy without T-tube implantation (group B). Three patients who underwent living donor liver transplantation and 3 choledochojejunostomy patients were excluded. Results: Between the two groups, there were no significant differences in clinical characteristics, including sex, age, indication of liver transplantation (hepatitis B virus, hepatitis C virus, alcoholic liver cirrhosis, or hepatocellular carcinoma), Child-Pugh classification, preoperative laboratory data, and operative, macroscopic and microscopic findings. Additionally, there were no significant differences in bile duct complications and overall survival rate. Of these 88 patients with orthotopic liver transplantation, 11 (12.5{\%}) developed biliary complications (10 male, 1 female). Seven patients had anastomostic stricture and underwent endoscopic retrograde cholangiopancreatography (ERCP) with stent implantation. In 5 of these patients ERCP and stent implantation failed, and surgery was done with successful results. Conclusions: Whether or not stent implantation is done during choledochocholedochostomy after OLT has no impact on the frequency of biliary complications or survival time. The biliary complications after liver transplantation can be managed by ERCP with stent implantation. If ERCP fails, surgical intervention should be considered immediately. {\circledC} 2006 S. Karger GmbH.",
keywords = "Biliary complication, Choledochocholedochostomy, Liver transplantation, T-tube, adult, alcohol liver cirrhosis, article, bile duct obstruction, biliary tract disease, choledochojejunostomy, controlled study, disease classification, endoscopic retrograde cholangiopancreatography, female, hepatitis B, Hepatitis B virus, hepatitis C, Hepatitis C virus, human, implantation, liver cell carcinoma, liver transplantation, major clinical study, male, microscopy, preoperative period, sex difference, statistical significance, stent, surgical technique, survival rate, T tube, treatment failure, treatment indication, treatment outcome",
author = "Chien-Hua Lin and Teng-Wei Chen and Jiun-Chou Shao and Huan-Fa Hsieh and Heng-Cheng Chu and Jyh-Cherng Yu and Yao-Chi Liu and Chung-Bao Hsieh",
note = "Export Date: 22 March 2016 CODEN: CGIHA 通訊地址: Hsieh, C.-B.; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, 325, Cheng-Kung Road, Taipei 114, Taiwan; 電子郵件: linjh93@yahoo.com.tw 參考文獻: Nuno, J., Vicente, E., Turrion, V.S., Pereira, F., Ardaiz, J., Cuervas, V., Barcena, R., Moreno, A., Biliary tract reconstruction after liver transplantation: With or without T-tube? (1997) Transplant Proc, 29, pp. 564-565; Scatton, O., Meunier, B., Cherqui, D., Boillot, O., Sauvanet, A., Boudjema, K., Launois, B., Soubrane, O., Randomized trial of choledochocholedochostomy with or without a T tube in orthotopic liver transplantation (2001) Ann Surg, 233, pp. 432-437; Randall, H.B., Wachs, M.E., Somberg, K.A., Lake, J.R., Emond, J.C., Ascher, N.L., Roberts, J.P., The use of the T tube after orthotopic liver transplantation (1996) Transplantation, 61, pp. 258-261; Rolles, K., Dawson, K., Novell, R., Hayter, B., Davidson, B., Burroughs, A., Biliary anastomosis after liver transplantation does not benefit from T tube splintage (1994) Transplantation, 57, pp. 402-404; Rerknimitr, R., Sherman, S., Fogel, E.L., Kalayci, C., Lumeng, L., Chalasani, N., Kwo, P., Lehman, G.A., Biliary tract complications after orthotopic liver transplantation with choledochocholedochostomy anastomosis: Endoscopic findings and results of therapy (2002) Gastrointest Endosc, 55, pp. 224-231; Schwartz, D.A., Petersen, B.T., Poterucha, J.J., Gostout, C.J., Endoscopic therapy of anastomostic bile duct strictures occurring after liver transplantation (2000) Gastrointest Endosc, 51, pp. 169-174; Khuroo, M.S., Al Ashgar, H., Khuroo, N.S., Khan, M.Q., Khalaf, H.A., Al-Sebayel, M., El Din Hassan, M.G., Biliary disease after liver transplantation: The experience of the King Faisal Specialist Hospital and Research Center, Riyadh (2005) J Gastroenterol Hepatol, 20, pp. 217-228; Pitt, H.A., Kaufman, S.L., Coleman, J., White, R.I., Cameron, J.L., Benign postoperative biliary strictures. Operate or dilate? (1989) Ann Surg, 210, pp. 417-425; Moser, M.A.J., Wall, W.J., Management of biliary problems after liver transplantation (2001) Liver Transpl, 7 (1 SUPPL.), pp. S46-S52; Orons, P.D., Sheng, R., Zajko, A.B., Hepatic artery stenosis in liver transplant recipients: Prevalence and cholangiographic appearance of associated biliary complications (1995) AJR Am J Roentgenol, 165, pp. 1145-1149",
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TY - JOUR

T1 - Biliary complications after liver transplantation

AU - Lin, Chien-Hua

AU - Chen, Teng-Wei

AU - Shao, Jiun-Chou

AU - Hsieh, Huan-Fa

AU - Chu, Heng-Cheng

AU - Yu, Jyh-Cherng

AU - Liu, Yao-Chi

AU - Hsieh, Chung-Bao

N1 - Export Date: 22 March 2016 CODEN: CGIHA 通訊地址: Hsieh, C.-B.; Division of General Surgery, Department of Surgery, Tri-Service General Hospital, 325, Cheng-Kung Road, Taipei 114, Taiwan; 電子郵件: linjh93@yahoo.com.tw 參考文獻: Nuno, J., Vicente, E., Turrion, V.S., Pereira, F., Ardaiz, J., Cuervas, V., Barcena, R., Moreno, A., Biliary tract reconstruction after liver transplantation: With or without T-tube? (1997) Transplant Proc, 29, pp. 564-565; Scatton, O., Meunier, B., Cherqui, D., Boillot, O., Sauvanet, A., Boudjema, K., Launois, B., Soubrane, O., Randomized trial of choledochocholedochostomy with or without a T tube in orthotopic liver transplantation (2001) Ann Surg, 233, pp. 432-437; Randall, H.B., Wachs, M.E., Somberg, K.A., Lake, J.R., Emond, J.C., Ascher, N.L., Roberts, J.P., The use of the T tube after orthotopic liver transplantation (1996) Transplantation, 61, pp. 258-261; Rolles, K., Dawson, K., Novell, R., Hayter, B., Davidson, B., Burroughs, A., Biliary anastomosis after liver transplantation does not benefit from T tube splintage (1994) Transplantation, 57, pp. 402-404; Rerknimitr, R., Sherman, S., Fogel, E.L., Kalayci, C., Lumeng, L., Chalasani, N., Kwo, P., Lehman, G.A., Biliary tract complications after orthotopic liver transplantation with choledochocholedochostomy anastomosis: Endoscopic findings and results of therapy (2002) Gastrointest Endosc, 55, pp. 224-231; Schwartz, D.A., Petersen, B.T., Poterucha, J.J., Gostout, C.J., Endoscopic therapy of anastomostic bile duct strictures occurring after liver transplantation (2000) Gastrointest Endosc, 51, pp. 169-174; Khuroo, M.S., Al Ashgar, H., Khuroo, N.S., Khan, M.Q., Khalaf, H.A., Al-Sebayel, M., El Din Hassan, M.G., Biliary disease after liver transplantation: The experience of the King Faisal Specialist Hospital and Research Center, Riyadh (2005) J Gastroenterol Hepatol, 20, pp. 217-228; Pitt, H.A., Kaufman, S.L., Coleman, J., White, R.I., Cameron, J.L., Benign postoperative biliary strictures. Operate or dilate? (1989) Ann Surg, 210, pp. 417-425; Moser, M.A.J., Wall, W.J., Management of biliary problems after liver transplantation (2001) Liver Transpl, 7 (1 SUPPL.), pp. S46-S52; Orons, P.D., Sheng, R., Zajko, A.B., Hepatic artery stenosis in liver transplant recipients: Prevalence and cholangiographic appearance of associated biliary complications (1995) AJR Am J Roentgenol, 165, pp. 1145-1149

PY - 2006

Y1 - 2006

N2 - Background: The purpose of this study was to report the morbidity and mortality of patients who undergo liver transplantation with or without T-tube implantation after choledochocholedochostomy as well as to discuss management of bile duct complications. Patients and Methods: From August 2001 to November 2005, a retrospective review of 94 orthotopic liver transplantations was conducted. 43 patients underwent choledochocholedochostomy with T-tube implantation (group A); 45 patients underwent choledochocholedochostomy without T-tube implantation (group B). Three patients who underwent living donor liver transplantation and 3 choledochojejunostomy patients were excluded. Results: Between the two groups, there were no significant differences in clinical characteristics, including sex, age, indication of liver transplantation (hepatitis B virus, hepatitis C virus, alcoholic liver cirrhosis, or hepatocellular carcinoma), Child-Pugh classification, preoperative laboratory data, and operative, macroscopic and microscopic findings. Additionally, there were no significant differences in bile duct complications and overall survival rate. Of these 88 patients with orthotopic liver transplantation, 11 (12.5%) developed biliary complications (10 male, 1 female). Seven patients had anastomostic stricture and underwent endoscopic retrograde cholangiopancreatography (ERCP) with stent implantation. In 5 of these patients ERCP and stent implantation failed, and surgery was done with successful results. Conclusions: Whether or not stent implantation is done during choledochocholedochostomy after OLT has no impact on the frequency of biliary complications or survival time. The biliary complications after liver transplantation can be managed by ERCP with stent implantation. If ERCP fails, surgical intervention should be considered immediately. © 2006 S. Karger GmbH.

AB - Background: The purpose of this study was to report the morbidity and mortality of patients who undergo liver transplantation with or without T-tube implantation after choledochocholedochostomy as well as to discuss management of bile duct complications. Patients and Methods: From August 2001 to November 2005, a retrospective review of 94 orthotopic liver transplantations was conducted. 43 patients underwent choledochocholedochostomy with T-tube implantation (group A); 45 patients underwent choledochocholedochostomy without T-tube implantation (group B). Three patients who underwent living donor liver transplantation and 3 choledochojejunostomy patients were excluded. Results: Between the two groups, there were no significant differences in clinical characteristics, including sex, age, indication of liver transplantation (hepatitis B virus, hepatitis C virus, alcoholic liver cirrhosis, or hepatocellular carcinoma), Child-Pugh classification, preoperative laboratory data, and operative, macroscopic and microscopic findings. Additionally, there were no significant differences in bile duct complications and overall survival rate. Of these 88 patients with orthotopic liver transplantation, 11 (12.5%) developed biliary complications (10 male, 1 female). Seven patients had anastomostic stricture and underwent endoscopic retrograde cholangiopancreatography (ERCP) with stent implantation. In 5 of these patients ERCP and stent implantation failed, and surgery was done with successful results. Conclusions: Whether or not stent implantation is done during choledochocholedochostomy after OLT has no impact on the frequency of biliary complications or survival time. The biliary complications after liver transplantation can be managed by ERCP with stent implantation. If ERCP fails, surgical intervention should be considered immediately. © 2006 S. Karger GmbH.

KW - Biliary complication

KW - Choledochocholedochostomy

KW - Liver transplantation

KW - T-tube

KW - adult

KW - alcohol liver cirrhosis

KW - article

KW - bile duct obstruction

KW - biliary tract disease

KW - choledochojejunostomy

KW - controlled study

KW - disease classification

KW - endoscopic retrograde cholangiopancreatography

KW - female

KW - hepatitis B

KW - Hepatitis B virus

KW - hepatitis C

KW - Hepatitis C virus

KW - human

KW - implantation

KW - liver cell carcinoma

KW - liver transplantation

KW - major clinical study

KW - male

KW - microscopy

KW - preoperative period

KW - sex difference

KW - statistical significance

KW - stent

KW - surgical technique

KW - survival rate

KW - T tube

KW - treatment failure

KW - treatment indication

KW - treatment outcome

U2 - 10.1159/000093318

DO - 10.1159/000093318

M3 - Article

VL - 22

SP - 73

EP - 78

JO - Visceral Medicine

JF - Visceral Medicine

SN - 2297-4725

IS - 2

ER -