Publication

Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy

Sutton, M. E., Bense, R. D., Lisman, T., van der Jagt, E. J., van den Berg, A. P. & Porte, R. J., Apr-2014, In : Liver Transplantation. 20, 4, p. 457-463 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Sutton, M. E., Bense, R. D., Lisman, T., van der Jagt, E. J., van den Berg, A. P., & Porte, R. J. (2014). Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy. Liver Transplantation, 20(4), 457-463. https://doi.org/10.1002/lt.23827

Author

Sutton, Michael E. ; Bense, Rico D. ; Lisman, Ton ; van der Jagt, Eric J. ; van den Berg, Aad P. ; Porte, Robert J. / Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy. In: Liver Transplantation. 2014 ; Vol. 20, No. 4. pp. 457-463.

Harvard

Sutton, ME, Bense, RD, Lisman, T, van der Jagt, EJ, van den Berg, AP & Porte, RJ 2014, 'Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy', Liver Transplantation, vol. 20, no. 4, pp. 457-463. https://doi.org/10.1002/lt.23827

Standard

Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy. / Sutton, Michael E.; Bense, Rico D.; Lisman, Ton; van der Jagt, Eric J.; van den Berg, Aad P.; Porte, Robert J.

In: Liver Transplantation, Vol. 20, No. 4, 04.2014, p. 457-463.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Sutton ME, Bense RD, Lisman T, van der Jagt EJ, van den Berg AP, Porte RJ. Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy. Liver Transplantation. 2014 Apr;20(4):457-463. https://doi.org/10.1002/lt.23827


BibTeX

@article{92bde341bc0a4b83aec6cb2b01a829e6,
title = "Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy",
abstract = "There is no consensus on the preferred type of biliary reconstruction for patients undergoing orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC). The aim of this study was to compare long-term outcomes after OLT for PSC using either duct-to-duct anastomosis or Roux-en-Y hepaticojejunostomy for biliary reconstruction. In a consecutive series of 98 adult patients undergoing OLT for PSC, 45 underwent duct-to-duct reconstruction, and 53 underwent Roux-en-Y biliary reconstruction. The median follow-up was 8.2 years (interquartile range = 3.9-14.5 years). The outcomes of the 2 groups were compared. There were no significant differences in patient demographics or general surgical variables between the groups. The overall patient and graft survival rates were similar for the 2 groups. The incidence of biliary strictures and biliary leakage within the first year after transplantation did not differ between the 2 groups. However, significantly more patients in the Roux-en-Y group suffered at least 1 episode of cholangitis within the first year (9% in the duct-to-duct group versus 25% in the Roux-en-Y group, P = 0.04). In addition, Roux-en-Y reconstruction was associated with a significantly higher rate of late-onset (>1 year after transplantation) nonanastomotic biliary strictures (NAS) in comparison with duct-to-duct reconstruction (24% versus 7% at 5 years and 30% versus 7% at 10 years, P = 0.01). In conclusion, duct-to-duct biliary reconstruction in patients with PSC is associated with lower rates of posttransplant cholangitis and late-onset NAS in comparison with Roux-en-Y hepaticojejunostomy. If technically and anatomically feasible, duct-to-duct anastomosis can be performed safely in patients undergoing OLT for PSC. Liver Transpl 20:457-463, 2014. (c) 2014 AASLD.",
keywords = "EN-Y CHOLEDOCHOJEJUNOSTOMY, RISK-FACTORS, RECURRENT CHOLANGITIS, CHOLANGIOCARCINOMA, STRICTURES",
author = "Sutton, {Michael E.} and Bense, {Rico D.} and Ton Lisman and {van der Jagt}, {Eric J.} and {van den Berg}, {Aad P.} and Porte, {Robert J.}",
year = "2014",
month = apr,
doi = "10.1002/lt.23827",
language = "English",
volume = "20",
pages = "457--463",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "Wiley",
number = "4",

}

RIS

TY - JOUR

T1 - Duct-to-duct reconstruction in liver transplantation for primary sclerosing cholangitis is associated with fewer biliary complications in comparison with hepaticojejunostomy

AU - Sutton, Michael E.

AU - Bense, Rico D.

AU - Lisman, Ton

AU - van der Jagt, Eric J.

AU - van den Berg, Aad P.

AU - Porte, Robert J.

PY - 2014/4

Y1 - 2014/4

N2 - There is no consensus on the preferred type of biliary reconstruction for patients undergoing orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC). The aim of this study was to compare long-term outcomes after OLT for PSC using either duct-to-duct anastomosis or Roux-en-Y hepaticojejunostomy for biliary reconstruction. In a consecutive series of 98 adult patients undergoing OLT for PSC, 45 underwent duct-to-duct reconstruction, and 53 underwent Roux-en-Y biliary reconstruction. The median follow-up was 8.2 years (interquartile range = 3.9-14.5 years). The outcomes of the 2 groups were compared. There were no significant differences in patient demographics or general surgical variables between the groups. The overall patient and graft survival rates were similar for the 2 groups. The incidence of biliary strictures and biliary leakage within the first year after transplantation did not differ between the 2 groups. However, significantly more patients in the Roux-en-Y group suffered at least 1 episode of cholangitis within the first year (9% in the duct-to-duct group versus 25% in the Roux-en-Y group, P = 0.04). In addition, Roux-en-Y reconstruction was associated with a significantly higher rate of late-onset (>1 year after transplantation) nonanastomotic biliary strictures (NAS) in comparison with duct-to-duct reconstruction (24% versus 7% at 5 years and 30% versus 7% at 10 years, P = 0.01). In conclusion, duct-to-duct biliary reconstruction in patients with PSC is associated with lower rates of posttransplant cholangitis and late-onset NAS in comparison with Roux-en-Y hepaticojejunostomy. If technically and anatomically feasible, duct-to-duct anastomosis can be performed safely in patients undergoing OLT for PSC. Liver Transpl 20:457-463, 2014. (c) 2014 AASLD.

AB - There is no consensus on the preferred type of biliary reconstruction for patients undergoing orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC). The aim of this study was to compare long-term outcomes after OLT for PSC using either duct-to-duct anastomosis or Roux-en-Y hepaticojejunostomy for biliary reconstruction. In a consecutive series of 98 adult patients undergoing OLT for PSC, 45 underwent duct-to-duct reconstruction, and 53 underwent Roux-en-Y biliary reconstruction. The median follow-up was 8.2 years (interquartile range = 3.9-14.5 years). The outcomes of the 2 groups were compared. There were no significant differences in patient demographics or general surgical variables between the groups. The overall patient and graft survival rates were similar for the 2 groups. The incidence of biliary strictures and biliary leakage within the first year after transplantation did not differ between the 2 groups. However, significantly more patients in the Roux-en-Y group suffered at least 1 episode of cholangitis within the first year (9% in the duct-to-duct group versus 25% in the Roux-en-Y group, P = 0.04). In addition, Roux-en-Y reconstruction was associated with a significantly higher rate of late-onset (>1 year after transplantation) nonanastomotic biliary strictures (NAS) in comparison with duct-to-duct reconstruction (24% versus 7% at 5 years and 30% versus 7% at 10 years, P = 0.01). In conclusion, duct-to-duct biliary reconstruction in patients with PSC is associated with lower rates of posttransplant cholangitis and late-onset NAS in comparison with Roux-en-Y hepaticojejunostomy. If technically and anatomically feasible, duct-to-duct anastomosis can be performed safely in patients undergoing OLT for PSC. Liver Transpl 20:457-463, 2014. (c) 2014 AASLD.

KW - EN-Y CHOLEDOCHOJEJUNOSTOMY

KW - RISK-FACTORS

KW - RECURRENT CHOLANGITIS

KW - CHOLANGIOCARCINOMA

KW - STRICTURES

U2 - 10.1002/lt.23827

DO - 10.1002/lt.23827

M3 - Article

VL - 20

SP - 457

EP - 463

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 4

ER -

ID: 16395499