scholarly journals Pure laparoscopic management of early biliary leakage after liver transplantation: Abdominal lavage and T-tube placement

2015 ◽  
Vol 21 (4) ◽  
pp. 561-563 ◽  
Author(s):  
Patricia Martínez-Ortega ◽  
Fernando Rotellar ◽  
Pablo Martí-Cruchaga ◽  
Gabriel Zozaya ◽  
Carlos Sánchez-Justicia ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Tube Placement ◽  
Biliary Leakage ◽  
Laparoscopic Management ◽  
T Tube ◽  
Abdominal Lavage

scholarly journals Pure laparoscopic management of early biliary leakage after liver transplantation: Abdominal lavage and T-Tube placement

2015 ◽  
Vol 21 (8) ◽  
pp. 1105-1106 ◽  
Author(s):  
Ailton Sepulveda ◽  
Raffaele Brustia ◽  
Fabiano Perdigao ◽  
Olivier Soubrane ◽  
Olivier Scatton
Keyword(s):  
Liver Transplantation ◽  
Tube Placement ◽  
Biliary Leakage ◽  
Laparoscopic Management ◽  
T Tube ◽  
Abdominal Lavage

scholarly journals Usefulness of T-Tube in Liver Transplantation: Still Effective or Outmoded Strategy?

2021 ◽  
Vol 2 (4) ◽  
pp. 379-386
Author(s):  
Niccolò Incarbone ◽  
Riccardo De Carlis ◽  
Leonardo Centonze ◽  
Livia Palmieri ◽  
Giuseppe Cordaro ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
High Risk ◽  
Postoperative Complications ◽  
Anastomotic Stricture ◽  
Low Risk ◽  
Biliary Complications ◽  
Tube Placement ◽  
Post Transplant ◽  
T Tube ◽  
High Risk Cohort

Introduction: T-tube placement during liver transplantation (LT) is still debated. We performed a retrospective study to evaluate the usefulness of T-tube after LT in two cohorts differing in post-transplant risk. Methods: A total of 327 LTs performed between 2015 and 2018 were included in the analysis. LTs from donation after circulatory death and living donation, split-liver transplants, and LTs with hepaticojejunostomy were excluded. T-tube was reserved for marginal grafts, high-risk recipients, and bile duct size discrepancy. A balance of risk (BAR) score of ≤9 defined the low-risk cohort (232 patients, 68 with and 164 without T-tube), while a BAR score of >9 defined the high-risk cohort (95 patients, 43 with and 52 without T-tube). Postoperative complications were estimated with the comprehensive complication index (CCI). Postoperative biliary complications were classified in anastomotic stricture (AS), non-anastomotic stricture (NAS), and biliary leakage (BL). Results: In the low-risk cohort, LTs with and without T-tube had similar rates of NAS (0 vs. 2.9%, p = 0.36), AS (2.9 vs. 2.4%, p = 0.83), and BL (1.4 vs. 2.4%, p = 0.64). Analogous outcomes were found in the high-risk cohort: NAS (0 vs. 0), AS (0 vs. 5.7%, p = 0.11), and BL (0 vs. 1.3%, p = 0.27). There were more postoperative complications among patients with T-tube, in both the low-risk (CCI 29 vs. 21, p < 0.001) and high-risk (CCI 51 vs. 29, p < 0.001) cohort. No differences in primary non-function, hepatic artery thrombosis, and mortality were observed. Conclusions: T-tube placement did not influence postoperative biliary complications. Although the two cohorts were normalized for post-transplant risk, LT recipients with T-tube had a more complicated course.

Percutaneous transhepatic T-tube placement for antegrade biliary drainage: a new technique.

Radiology ◽  
1980 ◽  
Vol 137 (2) ◽  
pp. 545-546 ◽  
Author(s):  
M S Sarrafizadeh ◽  
P K Philip ◽  
M L Goldman
Keyword(s):  
Biliary Drainage ◽  
New Technique ◽  
Tube Placement ◽  
T Tube ◽  
A New Technique

scholarly journals Successful treatment of extreme drug resistant Acinetobacter baumannii infection following a liver transplant

2020 ◽  
Vol 14 (04) ◽  
pp. 408-410 ◽  
Author(s):  
Muhammed Rasid Aykota ◽  
Tugba Sari ◽  
Sevda Yilmaz
Keyword(s):  
Liver Transplantation ◽  
Acinetobacter Baumannii ◽  
Blood Stream Infection ◽  
Organ Transplant ◽  
Drug Resistant ◽  
Biliary Leakage ◽  
Cadaveric Donor ◽  
Donor Liver Transplantation ◽  
Increased Risk ◽  
End Stage

Orthotopic liver transplantation is a life-saving procedure for patients with end-stage liver failure. However, Acinetobacter baumannii infections and acute rejection are important causes of morbidity and mortality following transplants. Here we present a case report of a cadaveric donor liver transplantation with infectious complications detected after transplantation. The patient was a 64-year-old female. Because of non-alcoholic steatohepatitis due to hepatic insufficiency (model for end-stage liver disease (MELD): 12; Child-Pugh: 9B), liver transplantation from a cadaveric donor was performed. Following the transplantation, the patient developed a blood stream infection, urinary tract infection (UTI) and postoperative wound infection from biliary leakage. A. baumannii was isolated from blood, urine and wound cultures. Imipenem (4×500 mg), tigecycline (2×50 mg) and phosphomycin (4×4 g) were administered intravenously (IV). On the 14th day of treatment, the bile fistula closed and there was no bacterial growth in blood and urine cultures. The patient was discharged with full recovery. The duration of a transplant patient’s hospital stay, intensive care unit stay, invasive interventions, blood transfusions and immunosuppressive treatments cause an increased risk of extensively drug-resistant (XDR) A. baumannii infections, and a high mortality rate is seen despite antibiotic treatment. Phosphomycin, used in combination therapy, may be an alternative in the treatment of XDR pathogens in organ transplant patients, due to its low side effect profile and lack of interaction with immunosuppressives.

Total Cervical Tracheal Stenosis: Treatment by Laser, Dilation, and Stenting

1989 ◽  
Vol 98 (11) ◽  
pp. 890-895 ◽  
Author(s):  
Stanley M. Shapshay ◽  
John F. Beamis ◽  
Jean-Francois Dumon
Keyword(s):  
Tracheal Stenosis ◽  
Carbon Dioxide Laser ◽  
Average Duration ◽  
Surgical Techniques ◽  
Initial Therapy ◽  
Tube Placement ◽  
T Tube ◽  
Endoscopic Laser ◽  
Laser Excision

Twelve patients with total cervical tracheal stenosis were treated by endoscopic laser excision (neodymium:yttrium aluminum garnet or carbon dioxide laser), bronchoscopic dilation, and prolonged stenting with a silicone T-tube. All patients had previous traumatic or prolonged endotracheal intubation requiring a tracheotomy and presented with aphonia as the major complaint. Multiple laser and dilation treatments were necessary in ten patients. Average duration of T-tube placement was 6 months. Excellent results (decannulation and good voice) were achieved in eight patients with a follow-up of 9 months to 6 years. Persistent granulation tissue and some degree of fibrosis were the most common complications (eight of 12 patients). Two patients died of medical complications. A high success rate with this endoscopic technique justifies this approach as our initial therapy, with open surgical techniques reserved for failure.

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

2007 ◽  
Vol 83 (976) ◽  
pp. 120-123 ◽  
Author(s):  
T. Li ◽  
Z.-S. Chen ◽  
F.-J. Zeng ◽  
C.-S. Ming ◽  
W.-J. Zhang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Biliary Complications ◽  
T Tube ◽  
Transplant Centre
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