The role of intrahepatic cholangiojejunostomy in liver transplant recipients after extensive destruction of the extrahepatic biliary system

Alan Norman Langnas, R. J. Stratta, R. P. Wood, C. F. Ozaki, J. S. Bynon, B. W. Shaw, M. Kalayoglu, E. G. Flickinger, J. R. Pickleman, C. E. Broelsch

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background. Extensive destruction of the extrahepatic biliary system after liver transplantation can be a catastrophic event. We present our experience with the use of intrahepatic cholangiojejunostomy (IHCJ) in this setting. Methods. From July 1985 through December 1991, 668 liver transplantations were performed in 583 patients. Seven patients required IHCJ. This technique involves creating an anastomosis between the jejunal mucosal and hepatic parenchyma/capsule with the use of a Roux-en-Y limb of bowel. There were four adults and three children. The clinical presentation included bile leak (n = 4), subhepatic abscess (n = 2), and intrahepatic abscess (n = 1). The probable cause of these events included hepatic arterial thrombosis (n = 4), occult bile leak (n = 2), and fungal cholangitis (n = 1). Results. After IHCJ, six of the seven patients are currently alive, with a mean follow-up of 28 months. The current liver function test results include a mean bilirubin of 0.7 mg/dl (range, 0.4 to 1.9 mg/dl), serum glutamic pyruvic transaminase of 69 units/L (range, 32 to 118 units/L), and γ-glutamyltranspeptidase of 118 IU/L (range, 111 to 265 IU/L). Conclusions. These results suggest that IHCJ is a safe and effective alternative to retransplantation in liver recipients with extensive destruction of the extrahepatic biliary system.

Original languageEnglish (US)
Pages (from-to)712-718
Number of pages7
JournalSurgery
Volume112
Issue number4
StatePublished - Jan 1 1992

Fingerprint

Extrahepatic Bile Ducts
Bile
Liver Transplantation
Abscess
Liver
Cholangitis
Liver Function Tests
Alanine Transaminase
Bilirubin
Capsules
Thrombosis
Extremities
Serum
Transplant Recipients

ASJC Scopus subject areas

  • Surgery

Cite this

Langnas, A. N., Stratta, R. J., Wood, R. P., Ozaki, C. F., Bynon, J. S., Shaw, B. W., ... Broelsch, C. E. (1992). The role of intrahepatic cholangiojejunostomy in liver transplant recipients after extensive destruction of the extrahepatic biliary system. Surgery, 112(4), 712-718.

The role of intrahepatic cholangiojejunostomy in liver transplant recipients after extensive destruction of the extrahepatic biliary system. / Langnas, Alan Norman; Stratta, R. J.; Wood, R. P.; Ozaki, C. F.; Bynon, J. S.; Shaw, B. W.; Kalayoglu, M.; Flickinger, E. G.; Pickleman, J. R.; Broelsch, C. E.

In: Surgery, Vol. 112, No. 4, 01.01.1992, p. 712-718.

Research output: Contribution to journalArticle

Langnas, AN, Stratta, RJ, Wood, RP, Ozaki, CF, Bynon, JS, Shaw, BW, Kalayoglu, M, Flickinger, EG, Pickleman, JR & Broelsch, CE 1992, 'The role of intrahepatic cholangiojejunostomy in liver transplant recipients after extensive destruction of the extrahepatic biliary system', Surgery, vol. 112, no. 4, pp. 712-718.
Langnas, Alan Norman ; Stratta, R. J. ; Wood, R. P. ; Ozaki, C. F. ; Bynon, J. S. ; Shaw, B. W. ; Kalayoglu, M. ; Flickinger, E. G. ; Pickleman, J. R. ; Broelsch, C. E. / The role of intrahepatic cholangiojejunostomy in liver transplant recipients after extensive destruction of the extrahepatic biliary system. In: Surgery. 1992 ; Vol. 112, No. 4. pp. 712-718.
@article{f89b25c7ffe64a9daa4c3dd6a9d52465,
title = "The role of intrahepatic cholangiojejunostomy in liver transplant recipients after extensive destruction of the extrahepatic biliary system",
abstract = "Background. Extensive destruction of the extrahepatic biliary system after liver transplantation can be a catastrophic event. We present our experience with the use of intrahepatic cholangiojejunostomy (IHCJ) in this setting. Methods. From July 1985 through December 1991, 668 liver transplantations were performed in 583 patients. Seven patients required IHCJ. This technique involves creating an anastomosis between the jejunal mucosal and hepatic parenchyma/capsule with the use of a Roux-en-Y limb of bowel. There were four adults and three children. The clinical presentation included bile leak (n = 4), subhepatic abscess (n = 2), and intrahepatic abscess (n = 1). The probable cause of these events included hepatic arterial thrombosis (n = 4), occult bile leak (n = 2), and fungal cholangitis (n = 1). Results. After IHCJ, six of the seven patients are currently alive, with a mean follow-up of 28 months. The current liver function test results include a mean bilirubin of 0.7 mg/dl (range, 0.4 to 1.9 mg/dl), serum glutamic pyruvic transaminase of 69 units/L (range, 32 to 118 units/L), and γ-glutamyltranspeptidase of 118 IU/L (range, 111 to 265 IU/L). Conclusions. These results suggest that IHCJ is a safe and effective alternative to retransplantation in liver recipients with extensive destruction of the extrahepatic biliary system.",
author = "Langnas, {Alan Norman} and Stratta, {R. J.} and Wood, {R. P.} and Ozaki, {C. F.} and Bynon, {J. S.} and Shaw, {B. W.} and M. Kalayoglu and Flickinger, {E. G.} and Pickleman, {J. R.} and Broelsch, {C. E.}",
year = "1992",
month = "1",
day = "1",
language = "English (US)",
volume = "112",
pages = "712--718",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - The role of intrahepatic cholangiojejunostomy in liver transplant recipients after extensive destruction of the extrahepatic biliary system

AU - Langnas, Alan Norman

AU - Stratta, R. J.

AU - Wood, R. P.

AU - Ozaki, C. F.

AU - Bynon, J. S.

AU - Shaw, B. W.

AU - Kalayoglu, M.

AU - Flickinger, E. G.

AU - Pickleman, J. R.

AU - Broelsch, C. E.

PY - 1992/1/1

Y1 - 1992/1/1

N2 - Background. Extensive destruction of the extrahepatic biliary system after liver transplantation can be a catastrophic event. We present our experience with the use of intrahepatic cholangiojejunostomy (IHCJ) in this setting. Methods. From July 1985 through December 1991, 668 liver transplantations were performed in 583 patients. Seven patients required IHCJ. This technique involves creating an anastomosis between the jejunal mucosal and hepatic parenchyma/capsule with the use of a Roux-en-Y limb of bowel. There were four adults and three children. The clinical presentation included bile leak (n = 4), subhepatic abscess (n = 2), and intrahepatic abscess (n = 1). The probable cause of these events included hepatic arterial thrombosis (n = 4), occult bile leak (n = 2), and fungal cholangitis (n = 1). Results. After IHCJ, six of the seven patients are currently alive, with a mean follow-up of 28 months. The current liver function test results include a mean bilirubin of 0.7 mg/dl (range, 0.4 to 1.9 mg/dl), serum glutamic pyruvic transaminase of 69 units/L (range, 32 to 118 units/L), and γ-glutamyltranspeptidase of 118 IU/L (range, 111 to 265 IU/L). Conclusions. These results suggest that IHCJ is a safe and effective alternative to retransplantation in liver recipients with extensive destruction of the extrahepatic biliary system.

AB - Background. Extensive destruction of the extrahepatic biliary system after liver transplantation can be a catastrophic event. We present our experience with the use of intrahepatic cholangiojejunostomy (IHCJ) in this setting. Methods. From July 1985 through December 1991, 668 liver transplantations were performed in 583 patients. Seven patients required IHCJ. This technique involves creating an anastomosis between the jejunal mucosal and hepatic parenchyma/capsule with the use of a Roux-en-Y limb of bowel. There were four adults and three children. The clinical presentation included bile leak (n = 4), subhepatic abscess (n = 2), and intrahepatic abscess (n = 1). The probable cause of these events included hepatic arterial thrombosis (n = 4), occult bile leak (n = 2), and fungal cholangitis (n = 1). Results. After IHCJ, six of the seven patients are currently alive, with a mean follow-up of 28 months. The current liver function test results include a mean bilirubin of 0.7 mg/dl (range, 0.4 to 1.9 mg/dl), serum glutamic pyruvic transaminase of 69 units/L (range, 32 to 118 units/L), and γ-glutamyltranspeptidase of 118 IU/L (range, 111 to 265 IU/L). Conclusions. These results suggest that IHCJ is a safe and effective alternative to retransplantation in liver recipients with extensive destruction of the extrahepatic biliary system.

UR - http://www.scopus.com/inward/record.url?scp=0026655717&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026655717&partnerID=8YFLogxK

M3 - Article

C2 - 1411942

AN - SCOPUS:0026655717

VL - 112

SP - 712

EP - 718

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 4

ER -