Outcomes of surgical repair of bile leaks and strictures after adult-to-adult living donor liver transplant

Authors


Corresponding author:John P. Roberts, MD, University of California San Francisco, 505 Parnassus Avenue, M896, PO Box 0780, San Francisco, CA 94143-0780, USA.
Tel.: 415 353 1555; fax: 415 353 8709;
e-mail: robertsj@surgery.ucsf.edu

Abstract

Melcher ML, Freise CE, Ascher NL, Roberts JP. Outcomes of surgical repair of bile leaks and strictures after adult-to-adult living donor liver transplant.
Clin Transplant 2010: 24: E230–E235. © 2010 John Wiley & Sons A/S.

Abstract:  We sought to determine factors that predict the successful surgical repair of biliary complications after adult living donor liver transplantation (ALDLT).

Methods:  Records of 82 consecutive ALDLT right lobe recipients were reviewed. Operations were performed on 19 recipients for biliary complications. Post-operative biliary complications were analyzed. Fisher’s exact test was used to identify variables that correlated with successful surgical repair.

Results:  A total of 29 recipients had biliary complications, of which 19 had a surgical repair. The five recipients, operated on for a stricture without history of leaks, did not develop further complications. However, nine of 14 with a history of a leak developed further complications after surgical repair (p-value = 0.044). All five who presented with a biliary complication more than 100 d after transplant had successful surgical repair; however, nine out of 13 who presented within 57 d had additional complications after repair.

Conclusions:  Operations for strictures after ALDLT are more successful than operations for leaks. Recipients with isolated biliary strictures after ALDLT can be managed surgically; however, recipients with history of a leak often require additional interventions after surgical repair.

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