Open AccessInfection rates with and without T‐tube splintage of common bile duct anastomosis in liver transplantation
Author(s) -
BenAriM Ziv,
Neville Louise,
Davidson Brian,
Rolles Keith,
Burroughs Andrew K.
Publication year - 1998
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.1998.tb00787.x
Subject(s) - medicine , anastomosis , surgery , liver transplantation , sepsis , common bile duct , leak , gallbladder , bile duct , duct (anatomy) , transplantation , gastroenterology , environmental engineering , engineering
Stenting the bile duct over a T‐tube after orthotopic liver transplantation (OLT) is the preferred method of biliary reconstruction. However, because of complications associated with the use of the T‐tube, we evaluated the effect of various biliary anastomoses following 100 consecutive OLT (83 records were available for long‐term evaluation) and assessed the clinical outcome of abandoning routine T‐tube splintage. Of 16 OLT recipients with T‐tube splintage (one died immediately following OLT and was excluded from the study), 6 patients (40 %) developed six episodes of septicaemia secondary to biliary and/or intra‐abdominal sepsis. Four of these six patients had a biliary leak (27 %). Of 57 patients with duct‐to‐duct anastomosis without T‐tube splintage, 7 patients developed biliary leak (12.3 %) and only 1 developed septicaemia (1.7%) secondary to biliary and intra‐abdominal sepsis (P = 0.0002). Of 11 patients with either a gallbladder conduit or Roux loop, only 1 patient had a biliary leak (9 %) and there were no septicaemic episodes. In conclusion, direct duct‐to‐duct anastomosis resulted in significantly less morbidity due to infection without T‐tube splintage than the use of a T‐tube following OLT, but there were no significant differences in leakage and stricture rates.