Biliary Complications in One Hundred Adult Liver Transplantations

Abstract

Background: Biliary complications are a common problem in liver transplantation (LT). Methods: We reviewed 100 consecutive adult LTs, including 10 retransplantations. Ten patients who survived for less than 1 month or developed hepatic artery thrombosis were excluded. Biliobiliary anastomosis was performed with a T-tube (CCT) (n = 25) or without it (CC) (n = 59), or biliodigestive anastomosis (Rouxen-Y) (n = 6) was used. Results: Biliary complications (8 anastomotic strictures and 9 bile leakages) occurred in 15 LTs. Surgical treatment was needed for seven strictures and two leakages. Complications tended to be more frequent with CCT than with CC (24% versus 12%). Biliary complications were often accompanied by cytomegalovirus disease and bacterial infections. After a median follow-up time of 5.2 years, total patient survival was 71% for all 100 LTs and 81% for those with biliary complications. Conclusions: Biliary complications are rather frequent after LTs; they are often preceded by infections but can be treated and do not cause excessive mortality. T-tubes are not to be recommended.

Key Words:

• Bile leakage
• biliary complications
• biliary stricture
• liver transplantation
• survival