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Gastrointestinal perforation after liver transplantation
Author(s) -
Fang Cheng,
Yan Sheng,
Liu Jianhua,
Zheng Shusen
Publication year - 2016
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12154
Subject(s) - medicine , perforation , liver transplantation , univariate analysis , surgery , gastroenterology , gastrointestinal perforation , ileum , risk factor , transplantation , duodenum , complication , liver disease , multivariate analysis , peritonitis , materials science , punching , metallurgy
Aim The aim of the present study was to evaluate the risk factors and outcomes of gastrointestinal perforation post‐liver transplantation. Patients and Methods Eleven patients were found to have complications as a result of gastrointestinal perforation post‐liver transplantation at our centre from M ay 2008 to F ebruary 2014. Seven of these patients were selected for statistical analysis. Each patient was randomly matched with six recipients in age (± 10 years), primary disease and sex. Factors, including cold ischaemic time, blood loss volume, previous hepatobiliary surgery history and 1‐year survival rate, were compared between the two groups. Results The sites of perforation were the stomach ( n = 2), duodenum ( n = 2), jejunum ( n = 1), ileum ( n = 3) and colon ( n = 3). Univariate analysis showed a significant difference in previous hepatobiliary surgery history ( P < 0.01). No difference was found in portal venous cross‐clamp time, cold ischaemic time, model for end‐stage liver disease score, body mass index, steroid therapy or blood type incompatib ility. Previous hepatobiliary surgery history was found to be an independent risk factor in the multivariate analysis ( P < 0.05). The 1‐year survival rate was lower in the perforation group ( P < 0.01). Conclusion Gastrointestinal perforation leads to a high rate of morbidity and mortality, and significantly decreases graft and recipient survival. A history of hepatobiliary surgery is a risk factor of this complication. Careful dissection and avoiding iatrogenic injury during operation are important.