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

Clin Transplant. 2010 Nov-Dec;24(6):E230-5. doi: 10.1111/j.1399-0012.2010.01289.x.

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.

MeSH terms

  • Adult
  • Aged
  • Bile Ducts / pathology*
  • Bile Ducts / surgery*
  • Biliary Tract Diseases / etiology
  • Biliary Tract Diseases / surgery*
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery*
  • Female
  • Humans
  • Liver Transplantation / adverse effects*
  • Living Donors*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult