Biliary tract complications in pediatric orthotopic liver transplantation.

摘要: Biliary tract complications are reported in 15% to 30% of orthotopic liver transplantations (OLTs). Since 1986, 53 OLTs were done 48 children with a mean age and weight 5.3 years 18.9 kg, respectively. Twenty-seven (51%) reduced grafts (RLG) 26 (49%) whole (WLG). 1988, 70% have been RLG. Choledochocholedochostomy (mean weight, 25 kg) T-tube (CC) or choledochojejunostomy (CJ) 14.5 24 (45%) 29 (55%) cases, The overall mortality was 19% but none the deaths related biliary problems. There 13 (24.5%) 11 patients including 7 leaks, 5 obstructions, 1 intrahepatic biloma. Leaks leading bile peritonitis managed simple suture drainage (4), Roux-en-Y loop (2), transection margin RLG (1). Obstruction documented cases associated hepatic artery thrombosis (HAT). Stenosis after CC reconstruction (2) required conversion CJ. Two had revision CJ because kinking common duct left lateral segment graft an anastomotic stricture 46 months OLT. last patient developed vanishing syndrome 4 posttransplant is awaiting retransplantation. One multiple episodes cholangitis HAT retransplanted. Neither type (RLG 25.9% v WLG 23.1%) nor (CC 25% 24%) influenced rate complications.(ABSTRACT TRUNCATED AT 250 WORDS)