Clinical trial on the cost‐effectiveness of T‐tube use in an established deceased donor liver transplantation program

  The aim of our study was to assess the advantages and disadvantages of T‐tube use in liver transplantation, with also paying attention to the economic costs derived from its use. Patients were prospectively randomized to T tube or no T tube. One hundred and seven patients, 53 with T tube and 54 without T tube, were analyzed. Minimum follow‐up was three months. Nine patients (8.4%) had bile leak: six in the T‐tube group (11.3%) and three in the group without T tube (5.5%), p = ns. Four patients (3.5%) had anastomotic biliary stenosis: one in the T‐tube group (1.8%) and three in the group without T tube, p = ns. Twenty of the 53 patients (37.7%) with T tube had T‐tube‐related complication. The number of diagnostic and therapeutic resources were higher in the T‐tube group compared with non‐T tube (81 and 17 vs. 18 and 10, respectively, p <0.05). The costs of therapeutic procedures required for the treatment of complications were 28 232 € in the T‐tube group vs. 16 088 € in the no T‐tube group, p <0.05. In conclusion, the systematic use of the T tube in biliary reconstruction in liver transplantation cannot be justified.