An Analysis Of Risk Factors For Biliary Complications After Orthotopic Liver Transplantation

Objective: To analyze the cases of retrograde reperfusion via vena cana in orthotopic liver transplantation in the Hepatobiliary surgery of 900 th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army(formerly Fuzhou General Hospital of Nanjing military command)from January 1,2005 to December 31,2017,and to explore the risk factors of biliary complications of retrograde reperfusion via vena cana in orthotopic liver transplantation,so as to summarize the experience of early diagnosis and prevention and treatment.Good prognosis.Methods: Retrospective analysis was made on the clinical data of 408 patients undergoing orthotopic liver transplantation with retrograde reperfusion via vena cana from January 1,2005 to December 31,2017 in the Hepatobiliary surgery of No.900 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army(formerly Fuzhou General Hospital of Nanjing Military command).According to whether the patients had biliary complications after operation,the patients were divided into biliary complications group and control group.According to the literature at home and abroad and the actual clinical practice of our center,the possible high-risk factors were screened out by single factor analysis first,and then by stepwise regression analysis according to the single factor analysis results.Result: A total of 408 cases of retrograde reperfusion via vena cana in orthotopic liver transplantation were collected.57 people(13.97%)had biliary complications,including 26 cases of Bile duct stone,The incidence was 36.62%,21 cases of Choledocholithiasis(including 11 cases of simple Choledocholithiasis,10 cases of bile duct stenosis with Choledocholithiasis),4 cases of intrahepatic and extrahepatic bile duct stones,28 cases of biliary stricture(19 cases of anastomotic stenosis and 9 cases of non-anastomosis).The incidence of stenosis of mouth was 39.44%;9 cases of bile leakage(8 cases of simple bile leakage and 1 case of bile duct drainage leakage),the incidence was 12.68%;6 cases of bile mud,the incidence was 8.44%;2 cases of biliary tract infection,the incidence rate was 2.82%,the overall median time of occurrence was 120 days(3-2040),different types of biliary complications,the median time of occurrence of bile duct stones was 566 days(52-2040);The median time of occurrence of bile mud was 142 days(53-513);The median time of occurrence of anastomotic stenosis was 63 days(50-400);the median time of occurrence of non-anastomotic stenosis was 166 days(88-377);the median time of occurrence of bile leakage was 11 days(3-91);and the median time of occurrence of biliary inflammation was 121 days(120-122).Univariate analysis showed that rejection was related to the occurrence of complications,with statistical significance.Rejection is a high risk factor for biliary complications after liver transplantation.Conclusion : The causes of biliary complications after liver transplantation are complex.The case analysis of our center shows that rejection is a high risk factor for biliary complications of retrograde reperfusion via vena cana in orthotopic liver transplantation.We should pay attention to the rejection after liver transplantation and take corresponding preventive measures so as to improve the prognosis and the survival rate after liver transplantation.