BILIARY COMPLICATIONS IN ORTHOTOPIC LIVER-TRANSPLANTATION - EXPERIENCE WITH A MODIFIED TECHNIQUE OF DUCT-TO-DUCT RECONSTRUCTION

被引：11

作者：

BELLI, L ^{[1
]}

DECARLIS, L ^{[1
]}

DELFAVERO, E ^{[1
]}

RONDINARA, G ^{[1
]}

MERONI, A ^{[1
]}

ZANI, B ^{[1
]}

RIMOLDI, P ^{[1
]}

CAZZULANI, A ^{[1
]}

BRAMBILLA, G ^{[1
]}

BEATI, C ^{[1
]}

机构：

[1] OSPED NIGUARDA CA GRANDA,DEPT SURG,TRANSPLANTAT UNIT,PIZZAMIGLIO 2,I-20162 MILAN,ITALY

来源：

TRANSPLANT INTERNATIONAL | 1991年 / 4卷 / 03期

关键词：

BILIARY RECONSTRUCTION; IN LIVER TRANSPLANTATION; LIVER TRANSPLANTATION;

D O I：

10.1007/BF00335338

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Biliary complications are described as frequent causes of morbidity during the postoperative course of orthotopic liver transplantation (OLTx), even in recent papers. The authors report here on their experience with duct-to-duct anastomosis as their method of choice for biliary reconstruction in a consecutive series of 100 OLTx in adult patients. The original technique, as described by Starzl, was modified by the authors by performing a wide, longitudinal plasty of both the donor and recipient bile ducts, joined together with two polidioxanone running sutures, producing the effect of a side-to-side anastomosis. This technique was used in all procedures, even when a significant discrepancy was evident between the ducts (n = 10). Follow-up was completed in 100% of the patients for a period of 2-40 months (mean 13.1 months). Four major complications (4%) occurred including hepatic abscesses due to ascending cholangitis, T-tube dislocation, partial occlusion by a branch of the T-tube at the anastomotic site, and disruption of the bile duct after T-tube removal. In four other patients, transient abdominal pain followed removal of the stent. Neither strictures nor fistulas were observed. Choledochocholedochostomy on a T-tube stent represents, in our experience, the technique of choice for biliary reconstruction in OLTx. The procedure, as described in the present study, proved to be safe in preventing strictures and leakages and appears to be feasible in nearly 100% of all adult patients undergoing OLTx.

引用

页码：161 / 165

页数：5

共 20 条

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