General Surgery Service and Liver Transplant Unit, Hospital Italiano de Buenos Aires General Surgery and Liver Transplant Unit, Hospital Alemán de Buenos Aires, Buenos Aires, Argentina.
HPB (Oxford). 2011 Aug;13(8):544-50. doi: 10.1111/j.1477-2574.2011.00322.x. Epub 2011 Jun 24.
Bile duct injury (BDI) is a severe complication that may arise during the surgical treatment of benign disease and a few patients will develop end-stage liver disease (ESLD) requiring a liver transplant (LT).
Analyse the experience using LT as a definitive treatment of BDI in Argentina.
A national survey regarding the experience of LT for BDI.
Sixteen out 18 centres reported a total of 19 patients. The percentage of LT for BDI from the total number of LT per period was: 1990-94 = 3.1%, 1995-99 = 1.6%, 2000-04 = 0.7% and 2005-09 = 0.2% (P < 0.001). The mean age was 45.7 ± 10.3 years (range 26-62) and 10 patients were female. The BDI occurred during cholecystectomy in 16 and 7 had vascular injuries. One patient presented with acute liver failure and the others with chronic ESLD. The median time between BDI and LT was 71 months (range 0.2-157). The mean follow-up was 8.3 years (10 months to 16.4 years). Survival at 1, 3, 5 and 10 years was 73%, 68%, 68% and 45%, respectively.
The use of LT for the treatment of BDI declined over the review period. LT plays a role in selected cases in patients with acute liver failure and ESLD.
胆管损伤（BDI）是一种严重的并发症，可能发生在良性疾病的手术治疗过程中，少数患者会发展为终末期肝病（ESLD），需要进行肝移植（LT）。
分析阿根廷使用 LT 作为 BDI 确定性治疗的经验。
一项关于 LT 治疗 BDI 经验的全国性调查。
18 个中心中的 16 个报告了总共 19 名患者。LT 治疗 BDI 的比例占同期 LT 总数的百分比为：1990-94 年=3.1%，1995-99 年=1.6%，2000-04 年=0.7%，2005-09 年=0.2%（P<0.001）。平均年龄为 45.7±10.3 岁（范围 26-62），10 名患者为女性。BDI 发生在胆囊切除术期间的 16 例中，7 例有血管损伤。1 例患者发生急性肝功能衰竭，其余患者发生慢性 ESLD。BDI 与 LT 之间的中位时间为 71 个月（范围 0.2-157）。平均随访时间为 8.3 年（10 个月至 16.4 年）。1、3、5 和 10 年的生存率分别为 73%、68%、68%和 45%。
在审查期间，LT 治疗 BDI 的使用呈下降趋势。LT 在急性肝功能衰竭和 ESLD 患者的一些选定病例中发挥作用。
