[Biliary complications in the follow-up of 54 orthotopic liver transplant patients].

UNLABELLED

We analyze the biliary tract complications after 54 orthotopic liver transplantation in 49 patients during a 2-year period. Biliary tract reconstruction was achieved by a choledochocholedochostomy over a t-tube in 47 cases and by a Roux-en-Y choledochojejunostomy in 7 cases (2 sclerosing cholangitis, 4 retransplants and 1 secondary biliary cirrhosis). The t-tube was removed between the 12-16 postoperative week in all cases except in two patients (2 and 3 postoperative week).

RESULTS

There was not intraoperative mortality. During the first postoperative month 8 patients died (16.3%) none of them because a biliary complications. The one year actuarial survival of patients was 74.6%. During the (first three postoperative months) we observed 5 patients with a bile leak (biloma). In 3 cases the ultrasonographic drainage was effective and in two cases a surgical drainage was necessary. After the 3rd postoperative month, four patients developed a biliary peritonitis after t-tube removal and a reoperation was required in all cases. Finally, 1 patient suffered a hilar biloma cavity due to hepatic artery thrombosis. We stress the low incidence of reoperations due to early biliary complications (2 cases) and the high incidence of biliary peritonitis after t-tube removal.