Experience using liver transplantation for the treatment of severe bile duct injuries over 20 years in Argentina: results from a National Survey

HPB (Oxford). 2011 Aug;13(8):544-50. doi: 10.1111/j.1477-2574.2011.00322.x. Epub 2011 Jun 24.

Abstract

Background: Bile duct injury (BDI) is a severe complication that may arise during the surgical treatment of benign disease and a few patients will develop end-stage liver disease (ESLD) requiring a liver transplant (LT).

Objective: Analyse the experience using LT as a definitive treatment of BDI in Argentina.

Patients and methods: A national survey regarding the experience of LT for BDI.

Results: Sixteen out 18 centres reported a total of 19 patients. The percentage of LT for BDI from the total number of LT per period was: 1990-94 = 3.1%, 1995-99 = 1.6%, 2000-04 = 0.7% and 2005-09 = 0.2% (P < 0.001). The mean age was 45.7 ± 10.3 years (range 26-62) and 10 patients were female. The BDI occurred during cholecystectomy in 16 and 7 had vascular injuries. One patient presented with acute liver failure and the others with chronic ESLD. The median time between BDI and LT was 71 months (range 0.2-157). The mean follow-up was 8.3 years (10 months to 16.4 years). Survival at 1, 3, 5 and 10 years was 73%, 68%, 68% and 45%, respectively.

Conclusions: The use of LT for the treatment of BDI declined over the review period. LT plays a role in selected cases in patients with acute liver failure and ESLD.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Argentina
  • Bile Ducts / injuries*
  • Chi-Square Distribution
  • Cholecystectomy / adverse effects
  • Digestive System Surgical Procedures / adverse effects*
  • Digestive System Surgical Procedures / mortality
  • End Stage Liver Disease / etiology
  • End Stage Liver Disease / mortality
  • End Stage Liver Disease / surgery*
  • Female
  • Health Care Surveys
  • Hepatectomy / adverse effects
  • Humans
  • Iatrogenic Disease
  • Liver Failure, Acute / etiology
  • Liver Failure, Acute / mortality
  • Liver Failure, Acute / surgery*
  • Liver Transplantation* / adverse effects
  • Liver Transplantation* / mortality
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • Time Factors
  • Treatment Outcome