Liver transplantation as last-resort treatment for patients with bile duct injuries following cholecystectomy: a multicenter analysis.
Bile duct injury
cholangitis
cholecystectomy
end-stage liver disease
liver transplantation
Journal
Annals of gastroenterology
ISSN: 1108-7471
Titre abrégé: Ann Gastroenterol
Pays: Greece
ID NLM: 101121847
Informations de publication
Date de publication:
2021
2021
Historique:
received:
01
06
2020
accepted:
20
07
2020
entrez:
8
1
2021
pubmed:
9
1
2021
medline:
9
1
2021
Statut:
ppublish
Résumé
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. Data from 8 high-volume LT centers relating to patients who underwent LT after suffering BDI during cholecystectomy were prospectively collected and retrospectively analyzed. 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. LT for selected patients with otherwise unmanageable BDI following cholecystectomy yields acceptable long-term outcomes.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
LT for selected patients with otherwise unmanageable BDI following cholecystectomy yields acceptable long-term outcomes.
Identifiants
pubmed: 33414630
doi: 10.20524/aog.2020.0541
pii: AnnGastroenterol-34-111
pmc: PMC7774661
doi:
Types de publication
Journal Article
Langues
eng
Pagination
111-118Informations de copyright
Copyright: © 2021 Hellenic Society of Gastroenterology.
Déclaration de conflit d'intérêts
Conflict of Interest: None
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