ORIGINAL ARTICLE

Impact of early biliary complications in liver transplantation in the presence or absence of a T-tube: a Chinese transplant centre experience

Tang Li^*, Zhi-Shui Chen^*, Fan-Jun Zeng, Chang-Sheng Ming, Wei-Jie Zhang, Dun-Gui Liu, Ji-Ping Jiang, Dun-Feng Du, Zhong-Hua Klaus Chen

Institute of Organ Transplantation (Key Laboratory of Organ Transplantation, Ministry of Education/Ministry of Health), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Correspondence to:
Correspondence to:
Professor Chen Zhishui
Institute of Organ Transplantation, Tongji Hospital, NO1095 Jiefang Road, Wuhan, China, 430030; zschen{at}tjh.tjmu.edu.cn

Background: Biliary complications continue to be an important determinant of the recipient’s survival rate after orthotopic liver transplantation (OLT). The objective of this study was to evaluate the incidence of early biliary complications in OLT in the presence or absence of a T-tube.

Methods: This retrospective study, based on inpatient data, focused on the relationship between T-tube placement and early biliary complications of 84 patients after OLT, from November 2002 to June 2005. Patients were divided into two groups based on whether or not a T-tube was used following bile duct reconstruction: T-tube group (group I, n = 33); non-T-tube group (group II, n = 51).

Results: 45.2% of OLT recipients had a malignant neoplasm. There were no significant differences in the demographic characteristics or operation data between the two groups. Overall, early biliary tract complications developed in 19.0% (16/84) of patients. The rate of early biliary complications was 30.3% (10/33) and 11.8% (6/51) in groups I II, respectively (p = 0.035). Biliary complications which were directly caused by T-tube placement occurred in 12.1% (4/33) of patients in group I. Overall, the percentage of malignant neoplasms, chronic viral cirrhosis, fulminant liver failure and other primary disease recipients with early biliary complications were 6.2%, 37.5%, 43.8% and 12.5%, respectively.

Conclusion: This study suggests that the use of a T-tube in Chinese patients undergoing OLT causes a higher incidence of early biliary complications. Most of the early biliary complications occurred in chronic viral cirrhosis and fulminant liver failure recipients.

Abbreviations: EST, endoscopic sphincterotomy; ERBD, endoscopic retrograde biliary drainage; ERCP, endoscopic retrograde cholangiopancreatography; OLT, orthotopic liver transplantation

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