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- W4313147978 abstract "Background: BC following LT are responsible for significant morbidity. No technical procedure during reconstruction has been associated with a risk reduction of BC. The placement of an intraductal removable stent (IRS) during reconstruction followed by its endoscopic removal showed feasibility and safety in a preliminary study. We aimed at evaluating the impact of an IRS on biliary complications (BC) following liver transplantation (LT). Methods: Multicentric Randomized Controlled Trial. Randomization was done during LT when a duct-to-duct biliary anastomosis was confirmed and when at least one of the bile stumps diameters was less than 7mm. In the IRS group, a custom-made segment of a T-tube was placed into the bile duct and removed endoscopically 4 to 6 months post LT. The primary endpoint was the incidence of biliary complications (fistulae and strictures) within six months post LT. Secondary criteria were complications related to the stent placement or extraction, including ERCP-related complications. Results: 235 patients were randomized in 7 LT centers from April 2015 to February 2019, 117 in IRS and 118 in control group. BC occurred in 31 patients (26.5%) in IRS groups vs 24 (20.3%) in control (p=0.27), including 16 (13.8%) and 15 (12.8%) strictures, respectively. IRS migration occurred in 14 patients (12.0%), cholangitis in 1 (0.9%), acute pancreatitis in 2 (1.8%) and difficulty during endoscopic extraction in 28 (28.6%). No predictive factor for BC was identified in the multivariate logistic regression. Conclusions: IRS does not prevent BC after LT and may require specific endoscopic expertise for removal. clinicaltrials.gov NCT02356939" @default.
- W4313147978 created "2023-01-06" @default.
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- W4313147978 date "2022-01-01" @default.
- W4313147978 modified "2023-10-16" @default.
- W4313147978 title "Duct-to-Duct Biliary Reconstruction with or without an Intraductal Removable Stent in Liver Transplantation: The BILIDRAIN-T Randomized Trial" @default.
- W4313147978 doi "https://doi.org/10.1016/j.hpb.2022.05.1230" @default.
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