Fibrin glue and biliary anastomotic leak after liver transplant.

OBJECTIVES: Fibrin sealants may prevent hemorrhage and biliary leakage after liver resection. We evaluated the effects of topical fibrin glue application on biliary anastomosis in deceased-donor liver transplant.

MATERIALS AND METHODS: From January 2011 to July 2013, fibrin glue was applied around the biliary anastomosis in 10 patients who had deceased-donor liver transplant (recipients: female, 8 patients; median age, 46.9 y) with end-to-end choledochocholedochostomy in 9 patients and hepaticojejunostomy in 1 patient. Biliary leakage was diagnosed with abdominal computed tomography.

RESULTS: Biliary leakage was observed in 1 patient at 18 days after deceased-donor liver transplant with end-to-end choledochocholedochostomy. This was treated with revision laparotomy and reconstruction of the biliary anastomotic leak with a hepaticojejunostomy and placement of an internal stent and fibrin glue; the patient 's condition improved. There were no perioperative deaths.

CONCLUSIONS: In deceased-donor liver transplant, application of fibrin glue at the biliary anastomosis may be associated with.