Laparoscopic surgery after orthotopic liver transplantation

Laparoscopic surgery is currently a widely accepted approach to several sur gical fields because of its advantages in terms of postoperative pain reduc tion and easy patient recovery. This approach may be useful even in solid-o rgan transplantation surgery as a diagnostic or treatment procedure in some surgical complications. Prom July 1991 to December 1998, we performed 142 liver transplantations on 129 patients. During the postoperative period, ma ny complications occurred Here we report two cases of intestinal occlusion caused by adhesions and three cases of lymphocele, all approached with lapa roscopic surgery. In all cases but one, we were able to complete the surger y by laparoscopic means; in one of the two occlusions, the procedure was sw itched to laparotomy because of a choledochojejunal anastomosis lesion. The three cases of lymphocele must be considered in a particular manner becaus e such cases, to our knowledge, have never been described in the literature . They always presented with a late-onset right pleural effusion and were l ocated in the retrohepatic, retrogastric, and left paracaval areas, close t o the esophageal hiatus. In conclusion, we believe a laparoscopic approach is a useful strategy to solve some surgical complications in patients who u nderwent orthotopic liver transplantation; however, the use of laparoscopic surgery in this field is strictly connected to the surgeon's experience an d versatility. Copyright (C) 2000 by the American Association for the Study of Liver Diseases.