Elsevier

Clinical Radiology

Volume 41, Issue 3, March 1990, Pages 190-194
Clinical Radiology

Original Paper
Biliary complications following orthotopic liver transplantation

https://doi.org/10.1016/S0009-9260(05)80966-3Get rights and content

The gall-bladder conduit anastomosis (choledocho-cholecysto-choledochostomy) has been the most frequently used technique for the biliary tract anastomosis in the Cambridge/King's College Hospital joint liver transplantation programme since 1976. Cholangiograms and interventional biliary procedures performed over a 3 year period were reviewed retrospectively. Seventy-six of 148 patients managed post-operatively at King's College Hospital were studied (79 transplants). Cholangiograms were abnormal in 63 (80%) transplants with biliary strictures; inspissated bile formation, bile leak and T-tube malposition occurring in 50, 23, 14 and three transplants respectively. Anastomotic strictures occurred most frequently, predominantly at the proximal anastomosis, and the presence of inspissated bile and the T-tube in relation to these contributed towards subsequent biliary obstruction. Non-anastomotic strictures in the donor biliary tract were associated with a high position of the T-tube tip at or above the liver hilum. Saline irrigation of the bile ducts for inspissated bile or its removal via the endoscope were effective measures in the management of biliary obstruction but percutaneous balloon dilatation and endoscopic stent insertion for biliary strictures were found to have a limited role.

References (13)

  • CalneRY

    A new technique for biliary drainage in orthotopic liver transplantation using the gallbladder as a pedicle graft conduit between the donor and recipient common bile ducts

    Annals of Surgery

    (1976)
  • CalneRY et al.

    Observations on preservation, bile drainage and rejection in 64 human orthotopic liver allografts

    Annals of Surgery

    (1977)
  • CalneRY et al.

    Improved survival after orthotopic liver grafting

    British Medical Journal

    (1981)
  • KromRAF et al.

    Choledocho-choledochostomy, a relatively safe procedure in orthotopic liver transplantation

    Surgery

    (1985)
  • LerutJ et al.

    Biliary tract complications in human orthotopic liver transplantation

    Transplantation

    (1987)
  • McMasterP et al.

    Biliary sludge following liver transplantation in man

    Transplantation

    (1978)
There are more references available in the full text version of this article.

Cited by (0)

View full text