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BILIARY STENTING IS ASSOCIATED WITH A REDUCED RISK OF BILIARY ANASTOMOTIC STRICTURE FOLLOWING LIVER TRANSPLANTATION
Author(s) -
Fink M. A.,
Wang B. Z.,
Muralidharan V.,
Christophi C.,
Jones R. M.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04132_3.x
Subject(s) - medicine , liver transplantation , anastomosis , stent , gastroenterology , transplantation , surgery
Aim Biliary complications are a common cause of morbidity following liver transplantation (LT). The risk factors for biliary anastomotic stricture (BAS) are poorly understood. We analysed the risk factors for BAS. Methods A respective review of a prospective database of patients who underwent LT between 1988 and 2006 in the Liver Transplant Unit Victoria was undertaken. Forty‐five of 502 (9%) LT carried out during this period were complicated by BAS. These cases were compared with 45 controls who underwent LT immediately preceding the cases. Donor, donor operation, recipient, recipient operation and donor/recipient compatibility factors were assessed. Non‐parametric data analysis was used. Results Cases were less likely to have had a biliary stent placed at LT than controls (74% vs 91%, respectively, P = 0.037). The BAS rate in patients who had a stent at LT was 7.3% compared with 25.5% for those who did not (P < 0.001). There was no difference in BAS rate with differences in stent type (infant feeding catheter vs T tube) or size. Although there were statistically significant differences between cases and controls for donor potassium (3.9+/−0.8 vs 4.0+/−0.4 mmol/L, respectively, P = 0.032) and HCO3 (25+/−3 vs 23+/−3 mmol/L, respectively, P = 0.021), the clinical significance of these differences is questionable. Conclusions The rate of BAS following LT is higher in patients who did not have a biliary stent placed at the time of LT, though a causative link has not been established.