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Endoscopic biliary stenting facilitates safe and early removal of T-tube in liver transplant patients.
Minerva Chir. 2005 Feb; 60(1):31-5.MC

Abstract

AIM

Duct to duct anastomosis in orthotopic liver transplant (OLT) patients have been traditionally performed with a t-tube in place for 3 to 6 months. Following removal of the t-tube a high incidence of biliary leakage has been reported.

METHODS

Prospective study to evaluate the role of endoscopic biliary stenting to facilitate early and uncomplicated t-tube removal. All patients with duct to duct biliary anastomosis who had a t-tube in situ, from January 1998 to December 2002 were included in this study.

RESULTS

There were 29 patients eligible for the study. Eight patients were not included due to early death. A protocol t-tube cholangiogram was performed in all patients, (median 12 days; range 4-47 days) followed by an endoscopic stent insertion (median 37 days; range 20-55 days). The stent was removed later (median 84 days; range 45-133 days). All complications related to the procedure were noted. Stent insertion was successful in all cases. In 2 patients a second endoscopic retrograde cholangiopancreatography (ERCP) was necessary, either because of failure to cannulate the papilla or to reposition the stent. There was a patient who presented a biliary leak due to stent displacement requiring a laparotomy. There were two further biliary leaks, one of them in an asymptomatic patient, which were managed conservatively. In addition 1 patient developed a mild case of postERCP pancreatitis.

CONCLUSIONS

In liver transplants patients with an end-to-end choledochostomy with a t-tube, endoscopic biliary stenting allows an early removal of the T tube, with few complications.

Authors+Show Affiliations

University Department of Surgery and Liver Transplant Unit, Royal Free Hospital, Royal Free and University College Medical School, Pond Street, London NW3 2QG, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15902051

Citation

Rolles, K, et al. "Endoscopic Biliary Stenting Facilitates Safe and Early Removal of T-tube in Liver Transplant Patients." Minerva Chirurgica, vol. 60, no. 1, 2005, pp. 31-5.
Rolles K, Fusai G, Rolando N, et al. Endoscopic biliary stenting facilitates safe and early removal of T-tube in liver transplant patients. Minerva Chir. 2005;60(1):31-5.
Rolles, K., Fusai, G., Rolando, N., Koti, R., Patch, D., Davidson, B. R., & Burroughs, A. K. (2005). Endoscopic biliary stenting facilitates safe and early removal of T-tube in liver transplant patients. Minerva Chirurgica, 60(1), 31-5.
Rolles K, et al. Endoscopic Biliary Stenting Facilitates Safe and Early Removal of T-tube in Liver Transplant Patients. Minerva Chir. 2005;60(1):31-5. PubMed PMID: 15902051.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic biliary stenting facilitates safe and early removal of T-tube in liver transplant patients. AU - Rolles,K, AU - Fusai,G, AU - Rolando,N, AU - Koti,R, AU - Patch,D, AU - Davidson,B R, AU - Burroughs,A K, PY - 2005/5/20/pubmed PY - 2005/8/19/medline PY - 2005/5/20/entrez SP - 31 EP - 5 JF - Minerva chirurgica JO - Minerva Chir VL - 60 IS - 1 N2 - AIM: Duct to duct anastomosis in orthotopic liver transplant (OLT) patients have been traditionally performed with a t-tube in place for 3 to 6 months. Following removal of the t-tube a high incidence of biliary leakage has been reported. METHODS: Prospective study to evaluate the role of endoscopic biliary stenting to facilitate early and uncomplicated t-tube removal. All patients with duct to duct biliary anastomosis who had a t-tube in situ, from January 1998 to December 2002 were included in this study. RESULTS: There were 29 patients eligible for the study. Eight patients were not included due to early death. A protocol t-tube cholangiogram was performed in all patients, (median 12 days; range 4-47 days) followed by an endoscopic stent insertion (median 37 days; range 20-55 days). The stent was removed later (median 84 days; range 45-133 days). All complications related to the procedure were noted. Stent insertion was successful in all cases. In 2 patients a second endoscopic retrograde cholangiopancreatography (ERCP) was necessary, either because of failure to cannulate the papilla or to reposition the stent. There was a patient who presented a biliary leak due to stent displacement requiring a laparotomy. There were two further biliary leaks, one of them in an asymptomatic patient, which were managed conservatively. In addition 1 patient developed a mild case of postERCP pancreatitis. CONCLUSIONS: In liver transplants patients with an end-to-end choledochostomy with a t-tube, endoscopic biliary stenting allows an early removal of the T tube, with few complications. SN - 0026-4733 UR - https://www.unboundmedicine.com/medline/citation/15902051/Endoscopic_biliary_stenting_facilitates_safe_and_early_removal_of_T_tube_in_liver_transplant_patients_ L2 - http://www.diseaseinfosearch.org/result/4282 DB - PRIME DP - Unbound Medicine ER -