Selective Indication of T-Tube in Liver Transplantation: Prospective Validation of the Results of a Randomized Controlled Trial

Autores de IIS La Fe

• Rafael López Andújar

  Autor

• Javier Maupoey Ibáñez

  Autor

• Vicente Ibáñez Pradas

  Autor

• Andrea Boscà Robledo

  Autor

• María García Eliz

  Autor

• Salvador Benlloch Pérez

  Autor

• Elena Montalva Martinez

  Autor

Participantes ajenos a IIS La Fe

• Escrig, J
• Granero, P
• Vila, JJ
• Orbis, JF

Grupos

• Hepatología experimental y Trasplante hepático

  Investigador Principal

  Laia Tolosa Pardo

• Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

  

  Leader

  Marina Berenguer Haym

Abstract

Background and Aims. T-tube placement during choledochocholedochostomy (CCS) associated with liver transplantation (LT) remains controversial. This study was designed to validate the results of an earlier prospective randomized controlled trial (RCT) on use versus nonuse of the T-tube during CCS associated with LT. Methods. Prospective cohort study. The primary outcome was the overall incidence of biliary complications (BCs). Results. In total, 405 patients were included, and the median overall monitoring period was 29 months (interquartile range: 13-47 months). Selective use of the T-tube reduced BCs (23% vs 13%; P = .003), of which 75% were type IIIa or less in the Clavien-Dindo classification. The overall BC rate did not differ between patients with versus without T-tube placement. Conclusions. We confirmed that selective use of a rubber T-tube during CCS associated with LT, following the principles established in our prospective RCT, reduced the rate of BC by 10% without detriment, even after enrolling patients at an a priori greater risk of BCs than were the RCT patients.