The benefit of placing a T-tube for duct-to-duct biliary reconstruction during orthotopic liver transplantation (OLT) remains controversial because it could be associated with specific complications, especially at the time of T-tube removal. While the utility of T-tube during OLT represents an eternal debate, only a few technical refinements of T-tube placement have been described since the report of the original technique by Starzl and colleagues. Herein, we present a novel technique of T-tube placement for duct-to-duct biliary reconstruction during OLT, using a tunneled retroperitoneal route. On the basis of our experience of 305 patients who benefitted from the reported technique, the placement of a tunneled retroperitoneal biliary T-tube appears to be safe and results in a low rate of biliary complications, especially at the time of T-tube removal.
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Intensive care unit
Model for end-stage liver disease
Orthotopic liver transplantation
Transjugular intrahepatic porto-systemic shunt
Tunneled retroperitoneal biliary T-tube
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JN and KM collected and analyzed the data and wrote the manuscript.
BD and JBC interpreted the data and critically revised the manuscript.
CD and JYM designed the study and critically revised the manuscript.
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The authors have no source of funding to disclose for the present work.
Conflict of Interest
The authors declare that they have no conflict of interest.
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Navez, J., Mohkam, K., Darnis, B. et al. Biliary Duct-to-Duct Reconstruction with a Tunneled Retroperitoneal T-Tube During Liver Transplantation: a Novel Approach to Decrease Biliary Leaks After T-Tube Removal. J Gastrointest Surg 21, 723–730 (2017) doi:10.1007/s11605-016-3313-x
- Liver transplantation
- Biliary reconstruction
- Bile leakage