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  • Title: Biliary tract reconstruction in liver transplantation.
    Author: Wall WJ, Grant DR, Mimeault RE, Girvan DP, Duff JH.
    Journal: Can J Surg; 1989 Mar; 32(2):97-100. PubMed ID: 2493330.
    Abstract:
    Refinements in biliary tract reconstruction and the frequent use of cholangiography have produced a marked decline in the number of deaths from biliary complications after liver transplantation. The authors' method of reconstruction differs from those of others in that it employs no stents or T tubes and retains the donor gallbladder, allowing access to the biliary tract for radiologic purposes in the post-transplant period. In a series of 161 consecutive liver transplants, the frequency of biliary complications was 13.6% (15 anastomotic and 7 gallbladder-related). Of three deaths that occurred in patients with biliary complications, one was due to the complication itself. A Roux-en-Y reconstruction with anastomosis to the donor duct was associated with the lowest anastomotic complication rate (2.2%). Upper abdominal surgery before transplantation, especially shunting, was a major risk factor for biliary complications.
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