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Clinical Trial
. 2001 Mar;233(3):432-7.
doi: 10.1097/00000658-200103000-00019.

Randomized trial of choledochocholedochostomy with or without a T tube in orthotopic liver transplantation

O Scatton  1 , B Meunier, D Cherqui, O Boillot, A Sauvanet, K Boudjema, B Launois, P L Fagniez, J Belghiti, P Wolff, D Houssin, O Soubrane
Affiliations
Clinical Trial

Randomized trial of choledochocholedochostomy with or without a T tube in orthotopic liver transplantation

O Scatton et al. Ann Surg. 2001 Mar.

Abstract

Objective: To compare the incidence of biliary complications after liver transplantation in patients undergoing choledochocholedochostomy reconstruction with or without T tube in a multicenter, prospective, randomized trial.

Summary background data: Several reports have suggested that biliary anastomosis without a T tube is a safe method of biliary reconstruction that could avoid complications related to the use of T tubes. No large prospective randomized trial has so far been published to compare the two techniques.

Methods: One hundred eighty recipients of orthotopic liver transplantation were randomly assigned to choledochocholedochostomy with (n = 90) or without (n = 90) a T tube in six French liver transplantation centers. All types of biliary complications were taken into account.

Results: The overall biliary complication rate was increased in the T-tube group, even though these complications did not lead to an increase in surgical or radiologic therapeutic procedures. The major significant complication was cholangitis in the T-tube group; this did not occur in the other group. The incidence of biliary fistula was 10% in the T-tube group and 2.2% in the group without a T tube. Other biliary complications were similar. The complication rate of cholangiography performed with the T tube was greater than with other types of biliary exploration. The graft and patient survival rates were similar in the two groups.

Conclusion: This study is the first large prospective, randomized trial of biliary complications with or without a T tube. The authors found an increase in the biliary complication rate in the T-tube group, which was linked to minor complications. The T tube did not provide a safer access to the biliary tree compared with the others types of biliary explorations. The authors recommend the performance of choledochocholedochostomy without a T tube in liver transplantation.

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Figures

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Figure 1. Biliary event-free survival in liver transplant recipients according to the presence or absence of a T tube.
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Figure 2. Liver graft survival according to the presence or absence of a T tube.
See this image and copyright information in PMC

References

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