Usefulness of External Biliary Stent Buried Suture for Reducing Stent-Related Complications In Liver Transplantation

Abstract

External bile stents may be used to prevent biliary complications. However, the external biliary stent itself has a risk of complications. This study evaluated the frequency and treatment of complications associated with external bile stent. From May 2015 to September 2019, 18 deceased donor liver transplantations (DDLTs) and 25 living donor liver transplantations (LDLTs) were performed. We retrospectively reviewed these patients' demographic profiles, type of transplantation and presence of biliary complications, external bile stent-related complications, and treatment results. Overall biliary complications occurred in 12 patients (27.9%): 3 strictures (6.9%), 2 leakages (4.6%), and 7 external bile stent-related complications (16.2%). Among the 7, 4 were self-removal or stent fractures at home, and 2 occurred after removal by a physician. One patient had ileus with peritonitis. Local peritonitis was controlled by antibiotics and fluid therapy, but 1 patient needed an operation because of intestinal obstruction with recurrent local peritonitis. All biliary complications occurred in LDLT, and external biliary stent-related complications also occurred only in LDLT, not in DDLT (P=.014). Interestingly, only 1 of 7 external bile stent-related complications occurred after we adopted the stent buried suture technique on the duodenum (P=.062). External bile stent-related complications were higher in LDLT than in DDLT. When performing external bile stent implantation, the stent buried suture technique will help reduce stent-related complications, especially in LDLT.