The Effect Of Different Types Of Sutures On Biliary Complications After Liver Transplantation In Adults

Objective:This paper aims to explore the effect of different types of sutures on BC after liver transplantation,and to provide reference for the selection of different types of sutures in clinical work.Method:A retrospective analysis of 335 cases of orthotopic liver transplantation(OLT)patients with DCD from September 2014 to August 2020 in liver transplantation center of Jilin University was conducted.According to the inclusion criteria and exclusion criteria,173 patients were divided into two groups according to different types of suture used in biliary anastomosis.173 patients were treated with continuous posterior wall,interrupted anterior wall and non absorbable suture.138 patients were treated with continuous posterior wall and interrupted anterior wall and non absorbable suture.173 patients who were treated with non absorbable suture were included in the non absorbable suture group,138 patients with absorbable suture were included in the absorbable suture group.The general information of patients,types of biliary complications,occurrence time and treatment methods were analyzed.SPSS23.0 software was used for statistical methods.For measurement data,K-S normality test was performed first,and X-ray was used for data conforming to normal distribution (?)± S means that independent sample t test was used for inter group comparison,m(p25-p75)was used for non conformity,and nonparametric rank sum test was used for inter group comparison.The counting data were expressed by constituent ratio(%),and the comparison between the two groups was performed by chi square test.P < 0.05,it was considered statistically significant.Result:In this study,a total of 311 patients,53 patients had BC,the total incidence was17.04%,the occurrence time was 10-630 days after liver transplantation,the median time was 60 days.There were 44 cases of anastomotic stenosis,3 cases of simple bile leakage,5 cases of anastomotic stenosis combined with bile leakage,and 1 case of anastomotic stenosis combined with calculus.In addition,there were 19 cases(6.11%)of early BC(within 1 month)and 34 cases(10.93%)of late BC(after 1 month).In the non absorbable suture group,there were 32 patients with BC,the incidence rate was18.49%,including 26 patients with simple biliary anastomotic stenosis,3 patients with biliary anastomotic stenosis and bile leakage,and 3 patients with simple biliary leakage complications.In the absorbable suture group,there were 21 patients with BC,the incidence rate was 15.21%,including 18 patients with simple anastomotic stricture,1 patient with anastomotic stricture and stones,and 2 patients with anastomotic stricture and bile leakage.In the non absorbable suture group,there were6 cases of BC in the early stage(within one month),the incidence rate was 3.47%,and 26 cases of BC in the late stage,the incidence rate was 15.03%;In the absorbable suture group,there were 13 cases of early BC(9.42%)and 8 cases of late BC(5.80%);The results showed that there was no significant difference in the incidence of BC,anastomotic stricture and bile leakage(P > 0.05).But there was significant difference in the incidence of early BC,especially in the incidence of early biliary anastomotic stenosis(P < 0.05);In the late stage of BC,especially in the late stage,the incidence of anastomotic stricture was also significantly different(P < 0.05).ConclusionIn adult liver transplantation with continuous posterior wall and intermittent anterior wall anastomoses,the choice of absorbable suture is prone to anastomotic stricture in the early stage(within 1 month),while the choice of non absorbable suture is prone to anastomotic stricture in the late stage(after 1 month);However,no matter what type of suture is used,there is no significant difference in the total incidence of biliary complications.