Biliary complications after orthotopic liver transplantation

Relevance. Biliary complications take the leading position among all possible complications after liver transplantation, their frequency varies from 10-15% to 30% in case of cadaveric liver transplantation, and up to 40% in case of transplantation from a living donor. They include: strictures and deformations of the anastomosis leading to mechanical jaundice, cholangitis and impaired graft function. The arisen pathology significantly worsens the prognosis, therefore prevention of anastomotic strictures, timely diagnostics and treatment are required. Purpose of the study. To reveal the frequency of biliary complications after orthotopic liver transplantation, to determine the factors contributing to their development.
Materials and methods. 264 operations for orthotopic liver transplantation were performed in the conditions of the State Autonomous Establishment of the Republican Clinical Hospital from 2019 to May 2025. Of them 258 – from a cadaveric donor, 6 – from a related donor. A total of 264 patients were retrospectively analyzed, including 77 males and 187 females. For statistical processing of the study results Microsoft Excel program was used to calculate the percentage of evaluation criteria.
Research results. The total incidence of biliary complications amounted to 10.6%. It has been established that the occurrence of biliary strictures, deformations and failure of biliobiliary anastomosis depends on the recipient's primary disease, the technique of biliobiliary anastomosis formation, and the method of drainage.
Conclusion. On the basis of the obtained data we can conclude that for essential decrease of biliary complications frequency it is necessary to use complex multidisciplinary approach, which includes: improvement of surgical technique, choice of optimal method of reconstruction and drainage of biliary tracts. Special attention should be paid to preventive measures in patients with aggravated biliary anamnesis, which will minimize the risk of biliary complications in the postoperative period.

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