16628692

Source:http://linkedlifedata.com/resource/pubmed/id/16628692

Download in:

Switch to

Custom View

Named Graph Language Inference

Statements in which the resource exists as a subject.
Predicate	Object
rdf:type	pubmed:Citation
lifeskim:mentions	umls-concept:C0001675, umls-concept:C0009566, umls-concept:C0023911, umls-concept:C0521378, umls-concept:C0796494, umls-concept:C1534709, umls-concept:C2348480
pubmed:issue	5
pubmed:dateCreated	2006-4-26
pubmed:abstractText	Biliary complications are common following split liver transplantation (SLT). We analyzed the incidence, treatment, and outcome of biliary complications following adult right lobe ex vivo SLT performed between November 1992 and January 2005. There were 72 patients, of which 70 were analyzed. Early postoperative deaths resulted in 2 being excluded from the analysis. There were 44 males (median age, 48 yr; range, 19-70 yr). Biliary reconstruction was by duct-to-duct (DD) anastomosis in 52 (74%) and Roux-en-Y hepaticojejunostomy (RYHJ) in 18 (26%) patients. Until mid-2001, no T-tube was used for DD anastomosis (DD/non-T-tube) in 26 (37%) patients; subsequent to this, DD over a T-tube (DD/T-tube) was performed in 26 (37%) patients. Eighteen (26%) biliary complications occurred in 16 patients. Two anastomotic leaks of RYHJ were associated with hepatic artery thrombosis. The most frequent biliary complication was parenchymal radical leak from the transected liver surface (11%; 8/70), with anastomotic leaks in 6% (4/70) and strictures in 4% (3/70). There were also 2 cases of biliary leaks from T-tube exit site following T-tube removal, and 1 leak from the donor cystic duct stump. DD anastomosis without a T-tube was associated with a higher rate of cut surface and anastomotic biliary leaks (7/26), compared to the DD/T-tube group (1/26; P = 0.05). Six patients (9%) died following biliary complications, including 3 due to cut surface leaks in the DD/non-T-tube group and 2 cases with fatal biliary peritonitis following T-tube removal. A patient in the RYHJ group died due to biliary sepsis associated with hepatic artery thrombosis. In conclusion, biliary complications following right lobe ex vivo SLT are associated with significant morbidity and mortality. Our results suggest that T-tube biliary drainage of DD anastomosis may reduce parenchymal cut surface and biliary anastomotic leaks. However, bile leak following T-tube removal could lead to potentially fatal biliary peritonitis, which should always be anticipated and treated promptly.
pubmed:language	eng
pubmed:journal	http://linkedlifedata.com/resource/pubmed/journal/100909185
pubmed:citationSubset	IM
pubmed:status	MEDLINE
pubmed:month	May
pubmed:issn	1527-6465
pubmed:author	pubmed-author:BramhallSimon RSR, pubmed-author:BuckelsJohn A CJA, pubmed-author:GunsonBridgetB, pubmed-author:JethwaParasP, pubmed-author:MayerDavidD, pubmed-author:MirzaDarius FDF, pubmed-author:SilvaMichael AMA, pubmed-author:WojcickiMaciejM
pubmed:issnType	Print
pubmed:volume	12
pubmed:owner	NLM
pubmed:authorsComplete	Y
pubmed:pagination	839-44
pubmed:dateRevised	2006-11-15
pubmed:meshHeading	pubmed-meshheading:16628692-Anastomosis, Surgical, pubmed-meshheading:16628692-Bile Duct Diseases, pubmed-meshheading:16628692-Humans, pubmed-meshheading:16628692-Liver, pubmed-meshheading:16628692-Liver Transplantation, pubmed-meshheading:16628692-Retrospective Studies
pubmed:year	2006
pubmed:articleTitle	Biliary complications following adult right lobe ex vivo split liver transplantation.
pubmed:affiliation	Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Edgbaston, Birmingham, United Kingdom.
pubmed:publicationType	Journal Article, Research Support, Non-U.S. Gov't