The use of the T tube after orthotopic liver transplantation

Henry B. Randall, Michael E. Wachs, Kenneth A. Somberg, John R. Lake, Jean C. Emond, Nancy L. Ascher, John P. Roberts

Research output: Contribution to journalArticlepeer-review

77 Scopus citations

Abstract

An end-to-end choledochocholedochostomy (CD) over a T tube or a Roux-en-Y choledochojejunostomy (CDJ) have been the standard method of biliary reconstruction following orthotopic liver transplantation (OLTx). The objective of this study was to assess whether or not use of the T tube leads to increased biliary tract complications. Biliary tract complications were categorized as bile leak, stenosis, or obstruction that required therapeutic intervention. OLTx was performed in 161 patients over an 18-month period. Fifty-one patients were excluded from the study leaving a total of 110 patients for evaluation. Fifty-nine had their bile duct reconstructed over a T tube (CD T tube, group I) while the remaining 51 patients underwent bile duct reconstruction without a T tube (CD, group II). No difference was noted between groups I and II in their survival rate, rate of conversion to Roux- en-Y CDJ, or biliary complication rates. Our results indicate that CD (i.e., without a T tube) is both a safe and effective technique to reconstruct the biliary tract following hepatic transplantation. Routine use of a T tube with a CD anastomosis is unnecessary in most liver transplant patients. In addition, the omission of a T tube has reduced the number of radiological procedures performed at our center.

Original languageEnglish (US)
Pages (from-to)258-261
Number of pages4
JournalTransplantation
Volume61
Issue number2
DOIs
StatePublished - Jan 27 1996

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