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2013, Number 4

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Revista Cubana de Cirugía 2013; 52 (4)

Liver transplantation, biliary anastomosis technique and complications observed in 10 year-work

Argüelles PO, Díaz MJ, Collera RS

Language: Spanish
References: 53
Page: 257-270
PDF size: 84.40 Kb.


ABSTRACT

Introduction: The liver transplantation is indicated in those hepatic diseases for which it is not possible to use other therapeutic measures (or they have failed), and the expected survival rate or the quality of life of the patient is lower than the expected from liver transplantation, provided that there is no contraindications for transplantation. Traditionally, choledocho-choledocho termino-terminal anastomosis used to be performed with separate points over the Kehr tube placed at the receptor choledocho and tutoring anastomosis.
Objectives: To determine the complications related to principal biliary tract repair and to define the relationship of the biliary anastomosis technique and the diagnosed biliary complications after transplantation.
Methods: A retrospective observational, descriptive and longitudinal study was conducted to characterize the biliary complications in liver transplantation. All the medical records of the patients, who underwent this procedure during the 1999-2009 period, were checked. Absolute and relative frequencies and summary measures for quantitative variables were used.
Results: Stenosis was more frequently diagnosed in patients with termino-terminal anastomosis with tutor, accounting for 50%. Abdominal pain and icterus were the predominant symptoms and signs. Of the transplanted patients, 65.8% presented with some type of biliary complications. Thirteen of them (34.2%) had unfavorable progression and 8 died.
Conclusions: Biliary tract is undoubtedly the technical aspect with highest morbimortality in transplanted patients, led by stenosis. The used technique is highly influential in this regard, icterus and pain are alarming signs to be considered for diagnosis, being retrograde endoscopic cholangiopancretography the real solution for many patients.


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