Abstract
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.
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Received: 13 May 1997 Received after revision: 17 October 1997 Accepted: 27 October 1997
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Ben-Ari, Z., Neville, L., Davidson, B. et al. Infection rates with and without T-tube splintage of common bile duct anastomosis in liver transplantation. Transpl Int 11, 123–126 (1998). https://doi.org/10.1007/s001470050115
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DOI: https://doi.org/10.1007/s001470050115