Reducing biliary morbidity in full graft deceased donor liver transplantation: is it really a matter of T-tube?

摘要

To the Editor:We read with great interest the study from Weiss et al, recently published in Annals of Surgery, reporting the results of biliary reconstruction in liver transplantation using side-to-side choledochocholedochos-tomy with or without a T-tube. First, we would like to congratulate the authors for this very interesting and well-conducted prospective trial, and for their outstanding results with a 1-year survival rate of 98% in the T-tube group.Whether the biliary anastomosis should be protected by an external biliary drainage in liver transplantation is a question that has been raised for a long time, and many reports recommend biliary reconstruction without a T-tube. Indeed, despite major technical progress, biliary complications remain the most common impaired outcome following liver transplantation, with a major economic impact and, at worst, may lead to graft loss and patient death.