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Outcomes after discontinuation of routine use of transanastomotic biliary stents in pediatric liver transplantation at a single site.
- Source :
-
Pediatric Transplantation . Aug2016, Vol. 20 Issue 5, p647-651. 5p. - Publication Year :
- 2016
-
Abstract
- Routine use of transanastomotic biliary stents (RTBS) for biliary reconstruction in liver transplantation ( LT) is controversial, with conflicting outcomes in adult randomized trials. Pediatric literature contains limited data. This study is a retrospective review of 99 patients who underwent first LT (2005-2014). In 2011, RTBS was discontinued at our center. This study describes biliary complications following LT with and without RTBS. 56 (56%) patients had RTBS. Median age at LT was 1.9 yr ( IQR 0.7, 8.6); 55% were female. Most common indication for LT was biliary atresia (36%). Most common biliary reconstruction was Roux-en-Y choledochojejunostomy (75% with RTBS, 58% without RTBS, p = 0.09). Biliary complications (strictures, bile leaks, surgical revision) occurred in 23% without significant difference between groups (20% with RTBS, 28% without RTBS, p = 0.33). Patients with RTBS had routine cholangiography via the tube at 6-8 wk; thus, significantly more patients with RTBS had cholangiograms (91% vs. 19%, p < 0.0001). There was no difference in the number of patients who required therapeutic intervention via endoscopic or percutaneous transhepatic cholangiography (11% with RTBS, 19% no RTBS, p = 0.26). Routine use of RTBS for biliary reconstruction in pediatric LT may not be necessary, and possibly associated with need for costlier, invasive imaging without improvement in outcomes. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 13973142
- Volume :
- 20
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Pediatric Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 116619583
- Full Text :
- https://doi.org/10.1111/petr.12729