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Rubber transcystic drainage reduces the post-removal biliary complications in liver transplantation: a matched case–control study

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Abstract

Purpose

Bile duct (BD) complications continue to be the “Achilles’ heel” of liver transplantation, and the utilization of bile duct drainage is still on debate. We describe the results of a less invasive rubber trancystic biliary drainage (TBD) compared to a standard silicone T-tube (TT).

Methods

The transplanted patients (n = 248), over a period of 5 years with a TBD (n = 20), were matched 1:2 with control patients with a TT (n = 40). Primary end points were the overall incidence of BD complications and graft and patient survival. Secondary end points included the complications after the drainage removal.

Results

Although the bile duct leakage rates were not significantly different between both groups, the TT group had a significantly higher rate of overall 1-year BD stenosis (40 versus 10 %) (p = 0.036). Three-year patient/graft survival rates were 83.2/80.1 and 84.4/84.4 % for the TT and TBD groups, respectively. The postoperative BD complications, after drainage removal (peritonitis and stenosis), were significantly reduced (p = 0.011) with the use of a TBD.

Conclusion

The use of rubber TBD in liver transplant recipients does not increase the number of BD complications compared to the T-tube. Furthermore, less BD anastomotic stenosis and post-removal complications were observed in the TBD group compared to the TT group.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics

Patients have given their informed consent and the study protocol has been approved by the institute’s committee on human research.

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Authors and Affiliations

  1. Department of General and Liver Transplant Surgery, University of Montpellier, Hôpital Saint Eloi, 80 avenue Augustin Fliche, 34295, Montpellier-Cedex 5, France

    F. Panaro, A. Glaise, M. Miggino, H. Bouyabrine, JP. Carabalona & F. Navarro

  2. Department of Abdominal Imaging, University of Montpellier, Hôpital Saint Eloi, 80 avenue Augustin Fliche, 34295, Montpellier-Cedex 5, France

    F. Panaro & B. Gallix

  3. Department of Surgery, Liver Transplant Unit, Montpellier University Hospital, School of Medicine, 80 avenue Augustin Fliche, 34295, Montpellier-Cedex 5, France

    F. Panaro

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  1. F. Panaro
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  2. A. Glaise
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  3. M. Miggino
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  4. H. Bouyabrine
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  5. JP. Carabalona
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  6. B. Gallix
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  7. F. Navarro
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Correspondence to F. Panaro.

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Panaro, F., Glaise, A., Miggino, M. et al. Rubber transcystic drainage reduces the post-removal biliary complications in liver transplantation: a matched case–control study. Langenbecks Arch Surg 398, 169–176 (2013). https://doi.org/10.1007/s00423-012-0970-4

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  • DOI: https://doi.org/10.1007/s00423-012-0970-4

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