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dc.contributor.authorHardy, Kenneth Johnen
dc.contributor.authorWang, B Zen
dc.contributor.authorJones, Robert Men
dc.identifier.citationAustralian and New Zealand Journal of Surgery; 66(3): 162-5en
dc.description.abstractBiliary complications remain a continuing problem in liver transplantation. The goals of this study were to document the frequency of biliary complications following orthotopic liver transplantation in the Victorian programme, and to examine associations with suspected risk factors with reference to biliary stenosis.Data were collected from 129 consecutive transplants in 123 patients (106 adults, 17 children) at the Austin Hospital, Melbourne during the period 1988-94. The 2 year actuarial survival was 88%. Biliary reconstruction was by end-to-end anastomosis in 89 patients and Roux-en-Y in 40. Complications were suspected on clinical, biochemical or microbiological evidence. Biliary stenoses were considered to be radiological evidence of duct narrowing.Biliary complications occurred in 19% and biliary stenosis in 8.5%. Of the stenoses, 1/35 occurred in the first 20 month period, 9/47 in the second and 1/47 in the third. There was a significant difference between the middle period and other periods (P<0.05, Chi-square test). This change may be related to incomplete flushing of bile from the donor liver. Recurrence of the original disease was suspected for one stenosis. The length of the donor bile duct from hilum to anastomosis, cold ischaemia time and total hepatic artery flow at transplant did not relate to stenosis. Cholangitis was not diagnosed in patients without strictures. Strictures were managed by dilatation (5/11) and by operative repair (6).Stenoses were not related to the length of the donor bile duct, cold ischaemia time or total hepatic artery flow. Meticulous adherence to the protocol for flushing out bile at the donor operation was associated with a significant reduction in frequency of biliary stenoses.en
dc.subject.otherActuarial Analysisen
dc.subject.otherAnastomosis, Roux-en-Y.adverse effectsen
dc.subject.otherAnastomosis, Surgical.adverse effects.methodsen
dc.subject.otherBile Duct Diseases.etiology.therapyen
dc.subject.otherBile Ducts.surgeryen
dc.subject.otherConstriction, Pathologic.etiology.therapyen
dc.subject.otherFollow-Up Studiesen
dc.subject.otherHepatic Artery.physiopathologyen
dc.subject.otherLiver Transplantation.adverse effects.methods.physiologyen
dc.subject.otherMiddle Ageden
dc.subject.otherProspective Studiesen
dc.subject.otherRegional Blood Flowen
dc.subject.otherRisk Factorsen
dc.subject.otherSurvival Analysisen
dc.titleBiliary complications after liver transplant: the Victorian experience.en
dc.typeJournal Articleen
dc.identifier.journaltitleAustralian and New Zealand Journal of Surgeryen
dc.identifier.affiliationVictorian Liver Transplant Unit, Austin Campus, Melbourne, Victoria, Australiaen
dc.type.austinJournal Articleen
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.cerifentitytypePublications- Liver Transplant Unit- (University of Melbourne)- Surgery- and Hepatology-
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