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Biliary complications after liver transplantation--523 consecutive cases in two centers.

机译:肝移植后胆道并发症-在两个中心连续523例。

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BACKGROUND/AIMS: Despite various surgical techniques, biliary tract complications (BC) remain a major source of morbidity after liver transplantation (LT). METHODOLOGY: Between April 2000 and November 2008, 523 LTs in 487 recipients (36 re transplantations) were performed as follows: 402 whole deceased donor graft LTs, and 121 partial liver transplantation: 75 living donor liver transplantation, 42 split liver transplantation, and 4 reduced size liver transplantation. RESULTS: Mean follow-up period was 935 days (range 1-3174), 1, 3 and 5-year survival rates were 78.7% 74.2% and 74.2%, respectively. One hundred twenty seven patients--from 487 (26%), developed (after 135 LT) 150 singular BC (in total were 181 BC). Sixty four (of 85) bile leaks (75.29%) were early BC, while 53 (of 63) stenosis (84.1%) were late BC. BC does not influenced significantly patients and graft survival (p > 0.6). From 102 deaths, 8 were due to BC (1.6%) and in only 14 (2.67%) graft loss of 523 LT BC had the main role. Multiple ducts, multiple biliary anastomosis and RYHJ determine BC if compared to a single duct graft. Moreover, ductoplasty, graft type and HAT were independent risk factors. CONCLUSION: Biliary complications are common after LT but are rarely an isolated cause of death.
机译:背景/目的:尽管有各种外科手术技术,胆道并发症(BC)仍然是肝移植(LT)后发病的主要来源。方法:在2000年4月至2008年11月之间,对487位接受者进行了523次LT(36次移植),方法如下:402例完全死去的供体移植LT和121例部分肝移植:75例活体供肝移植,42例分体肝移植和4例缩小肝移植尺寸。结果:平均随访期为935天(范围1-3174),第1,第3和第5年生存率分别为78.7%,74.2%和74.2%。 127名患者-来自487名(26%),发展成(在135 LT后)150 BC(共181 BC)。在85例胆漏中,有64例(75.29%)在BC早期,而53例(63种)狭窄(84.1%)在BC晚期。 BC对患者和移植物存活率没有显着影响(p> 0.6)。在102例死亡中,有8例归因于BC(1.6%),而在仅14例(2.67%)中,523 LT BC的移植损失是主要原因。与单管移植相比,多管,多胆管吻合和RYHJ决定了BC。此外,导管成形术,移植物类型和HAT是独立的危险因素。结论:胆道并发症在LT后很常见,但很少是单独的死亡原因。

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