Fibrin glue and biliary anastomotic leak after liver transplant.

OBJECTIVES

Fibrin sealants may prevent hemorrhage and biliary leakage after liver resection. We evaluated the effects of topical fibrin glue application on biliary anastomosis in deceased-donor liver transplant.

MATERIALS AND METHODS

From January 2011 to July 2013, fibrin glue was applied around the biliary anastomosis in 10 patients who had deceased-donor liver transplant (recipients: female, 8 patients; median age, 46.9 y) with end-to-end choledochocholedochostomy in 9 patients and hepaticojejunostomy in 1 patient. Biliary leakage was diagnosed with abdominal computed tomography.

RESULTS

Biliary leakage was observed in 1 patient at 18 days after deceased-donor liver transplant with end-to-end choledochocholedochostomy. This was treated with revision laparotomy and reconstruction of the biliary anastomotic leak with a hepaticojejunostomy and placement of an internal stent and fibrin glue; the patient 's condition improved. There were no perioperative deaths.

CONCLUSIONS

In deceased-donor liver transplant, application of fibrin glue at the biliary anastomosis may be associated with.