A PROSPECTIVE RANDOMIZED TRIAL OF BILE-DUCT RECONSTRUCTION AT LIVER-TRANSPLANTATION - T-TUBE OR NO T-TUBE

A prospective randomised study of end-to-end bile duct reconstruction with or without T-tube drainage during orthotopic liver transplantatio n (OLT) was undertaken in 60 patients well matched for age, sex, aetio logy of liver disease, operative blood loss, cold ischaemic time, preo perative serum bilirubin level and Child-Pugh score. Significant bilia ry complications in the T tube group occurred in five patients and inc luded bile duct stricture (n = 2), bile leak/peritonitis (n = 1) and c holangitis (n = 2). Bile duct strictures occurred in six patients in t he no T tube group (P > 0.05, NS). Hepatic artery stenosis was identif ied in one patient from each group in association with a biliary stric ture. Biliary complications in both groups were associated with a prol onged graft cold ischaemic time (P < 0.01), As no significant differen ce was noted in the number of early and late biliary complications bet ween the two groups, the routine use of a T tube has been discontinued .