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Surgical Outcome and Proposed Strategy for Biliary Stricture after Living Donor Liver Transplantation: A Single Center Analysis.
MedLine Citation:
PMID:  23282735     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background/Aims: To clarify the surgical outcome and propose an appropriate strategy for biliary stricture (BS) treatment after living donor liver transplantation (LDLT). Methodology: Among 53 patients who underwent LDLT at our institute, 45 patients had duct-to-duct anastomosis. Of these, 33 who survived for at least 12 months after LDLT comprised the study group. Clinical parameters, BS treatment outcomes, and predictive factors for long-term patency were investigated. Results: Eleven patients developed BS. Biliary leakage occurred significantly more frequently, and the number of external biliary tubes was significantly lower than the number of graft bile-duct openings, in the BS group compared with the non-BS group (p=0.001 and 0.004). Multivariate analysis showed that the number of external biliary tubes was the only risk factor. Long-term patency was achieved in two patients in whom stents were retained for more than 20 months, which was significantly longer than in other patients (p=0.01). Identical stent-retention for more than 6 months was a risk factor for cholangitis. Conclusions: The number of external biliary tubes should match the number of graft bile-duct openings. When BS occurs, the duration of stent retention should be more than 20 months, and stents should be exchanged at least every 6 months.
Authors:
Kazuhisa Takeda; Kuniya Tanaka; Takafumi Kumamoto; Kazunori Nojiri; Ryutaro Mori; Koichi Taniguchi; Ryusei Matsuyama; Kensuke Kubota; Noritoshi Kobayashi; Itaru Endo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-3
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  60     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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