Effectiveness of Variceal Band Application in Preventing Bile Leakage Associated With Trans-Cystic Feeding Catheter in Living-Donor Liver Transplantation.

Abstract

Objective: Despite advancements in surgical techniques, biliary complications remain a significant concern in liver transplantation. This study evaluated the effectiveness of applying a variceal band to the cystic duct stump in preventing bile leakage in patients with a trans-cystic feeding catheter.

Methods: The medical records of 328 liver transplant recipients between April 2022 and June 2024 were retrospectively reviewed. A total of 170 patients with trans-cystic external catheters were included in the study. Of these, 116 patients underwent variceal band application to the cystic duct stump, while 54 did not. The 2 groups were compared regarding demographic characteristics, graft weight, number of bile ducts, presence of bile leakage, and MELD scores.

Results: Among the 170 patients who underwent living-donor liver transplantation (LDLT), 58.8% were male, and 41.2% were female. Graft weight was significantly higher in the group with the variceal band application (p < .05). Bile leakage from the cystic duct stump occurred in 2 patients in the group without variceal banding, whereas no bile leakage was observed in the variceal band group. These 2 cases were successfully treated with percutaneous catheter placement under radiologic guidance.

Conclusion: The variceal band application is an effective and promising method for reducing bile leakage in LDLT patients utilizing a trans-cystic feeding catheter. However, multicenter studies with larger patient cohorts are necessary to more definitively assess the safety and efficacy of this technique.