Τίτλος:
Liver transplantation as last-resort treatment for patients with bile duct injuries following cholecystectomy: A multicenter analysis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background Liver transplantation (LT) has been used as a last resort in patients with end-stage liver disease due to bile duct injuries (BDI) following cholecystectomy. Our study aimed to identify and evaluate factors that cause or contribute to an extended liver disease that requires LT as ultimate solution, after BDI during cholecystectomy. Methods Data from 8 high-volume LT centers relating to patients who underwent LT after suffering BDI during cholecystectomy were prospectively collected and retrospectively analyzed. Results Thirty-four patients (16 men, 18 women) with a median age of 45 (range 22-69) years were included in this study. Thirty of them (88.2%) underwent LT because of liver failure, most commonly as a result of secondary biliary cirrhosis. The median time interval between BDI and LT was 63 (range 0-336) months. There were 23 cases (67.6%) of postoperative morbidity, 6 cases (17.6%) of post-transplant 30-day mortality, and 10 deaths (29.4%) in total after LT. There was a higher probability that patients with concomitant vascular injury (hazard ratio 10.69, P=0.039) would be referred sooner for LT. Overall survival following LT at 1, 3, 5 and 10 years was 82.4%, 76.5%, 73.5% and 70.6%, respectively. Conclusion LT for selected patients with otherwise unmanageable BDI following cholecystectomy yields acceptable long-term outcomes. © 2021 Hellenic Society of Gastroenterology.
Συγγραφείς:
Tsaparas, P.
Machairas, N.
Ardiles, V.
Krawczyk, M.
Patrono, D.
Baccarani, U.
Cillo, U.
Aandahl, E.M.
Cotsoglou, C.
Espinoza, J.L.
Claría, R.S.
Kostakis, I.D.
Foss, A.
Mazzaferro, V.
De Santibañes, E.
Sotiropoulos, G.C.
Περιοδικό:
ANNALS OF GASTROENTEROLOGY
Εκδότης:
Hellenic Society of Gastroenterology
Λέξεις-κλειδιά:
alanine aminotransferase; aspartate aminotransferase; gamma glutamyltransferase, adult; aged; Article; bile duct injury; bile leakage; biliary cirrhosis; biliary peritonitis; blood vessel injury; cholangiography; cholangitis; cholecystectomy; cholecystitis; cholelithiasis; cholestasis; clinical article; controlled study; end stage liver disease; endoscopic retrograde cholangiopancreatography; female; human; liver cell carcinoma; liver cirrhosis; liver failure; liver resection; liver transplantation; major clinical study; male; middle aged; morbidity; mortality; multicenter study; open surgery; operation duration; overall survival; peritonitis; postoperative complication; probability; prospective study; retrospective study; risk factor; sepsis; survival rate; wound infection
DOI:
10.20524/aog.2020.0541
