NDLI: BILIARY COMPLICATIONS AFTER LIVER TRANSPLANTATION

Content Provider	Scientific Electronic Library Online (SciELO)
Author	COELHO, Júlio Cezar Uili LEITE, Lucas de Oliveira MOLENA, Antonio FREITAS, Alexandre Coutinho Teixeira de MATIAS, Jorge Eduardo Fouto
Abstract	ABSTRACT Background: Biliary reconstitution has been considered the Achilles’s heel of liver transplantations due to its high rate of postoperative complications. Aim: To evaluate the risk factors for occurrence of biliary strictures and leakages, and the most efficient methods for their treatment. Method: Of 310 patients who underwent liver transplantation between 2001 and 2015, 182 medical records were retrospectively analyzed. Evaluated factors included demographic profile, type of transplantation and biliary reconstitution, presence of vascular and biliary complications, their treatment and results. Results: 153 (84.07%) deceased donor and 29 (15.93%) living donor transplantations were performed. Biliary complications occurred in 49 patients (26.92%): 28 strictures (15.38%), 14 leakages (7.7%) and seven leakages followed by strictures (3.85%). Hepatic artery thrombosis was present in 10 patients with biliary complications (20.4%; p=0,003). Percutaneous and endoscopic interventional procedures (including balloon dilation and stent insertion) were the treatment of choice for biliary complications. In case of radiological or endoscopic treatment failure, surgical intervention was performed (biliodigestive derivation or retransplantation (32.65%). Complications occurred in 25% of patients treated with endoscopic or percutaneous procedures and in 42.86% of patients reoperated. Success was achieved in 45% of patients who underwent endoscopic or percutaneous procedures and in 61.9% of those who underwent surgery. Conclusion: Biliary complications are frequent events after liver transplantation. They often require new interventions: endoscopic and percutaneous procedures at first and surgical treatment when needed. Hepatic artery thrombosis increases the number of biliary complications.
Related Links	http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0102-67202017000200127&lng=en&nrm=iso http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202017000200127&lng=en&nrm=iso
Starting Page	127
Ending Page	131
Page Count	5
File Format	PDF
ISSN	01026720
DOI	10.1590/0102-6720201700020011
Journal	ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
Issue Number	2
Volume Number	30
Language	English Portuguese
Publisher	Colégio Brasileiro de Cirurgia Digestiva
Publisher Date	2017-06-01
Access Restriction	Open
Subject Keyword	Hepatic transplantation Biliary stenosis Biliary fistula Biliary complications Postoperative complications. Transplante de fígado Estenose biliar Fístula biliar Complicações biliares Complicações pós-operatórias.
Alternative Title	COMPLICAÇÕES BILIARES PÓS-TRANSPLANTE HEPÁTICO
Content Type	Text
Resource Type	Article
Subject	Gastroenterology Surgery

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