Incidencia, factores de riesgo y tratamiento de las complicaciones biliares del trasplante hepático

Abstract

Introduction: Biliary tract complications (BC) are cause of mortality after liver transplantation (LT). There are different treatment alternatives for this complication. Aim: to determinate incidence, risk factors and treatment of biliary complications after LT. Materials and Methods: A retrospective descriptive cohort of patients undergoing LT between March 1994 and March 2009. Risk factors and incidence for BC were explored. Also the BC impact on overall survival on LT patients was assessed. We used SPSS 15.0 for statistical analysis and considered a significant p value less than 0.05. Results: 107 LT were performed in 102 patients. In 30 (28%) there was some biliary complication. Ten (33.3%) were early complications (< 3 months) and 20 (66.7%) were late (≥ 3 month). Anastomotic stricture was the more frequent BC. The gender male recipient, the cold ischemic time and biliary reconstruction technique without tutor were associated with an increased risk for BC. Endoscopic treatment of biliary stricture was successful in 91% of cases at one year follow up. Three (10%) patients died due to BC or their long-term treatment. Conclusions: Biliary Complications after Liver Transplantation are frequent and are cause of mortality. Decrease cold ischemic time and improve techniques for biliary reconstruction could reduce the high incidence of this complication.