Pediatric T-tube in adult liver transplantation: Technical refinements of insertion and removal

Table 1 Patients’ characteristics and surgical data

Variable	Study population n = 72, median (IQR)/n
Male sex	61 (84.7%)
Recipient age (yr)	57 (50-61)
Body mass index (kg/m2)	27 (23-29)
Underlying liver disease
Hepatitis C virus	21 (29.2%)
Hepatitis B virus	7 (9.7%)
Alcohol-related liver disease	25 (34.7%)
Primary biliary cirrhosis	2 (2.8%)
Polycystic liver disease	2 (2.8%)
Acute liver failure	4 (5.6%)
Other	11 (15.3%)
HCC	41 (56.9%)
MELD score	17 (12-22)
Donor age (yr)	62 (45-73)
Use of temporary porto-caval shunt	29 (40.3%)
Use of veno-venous bypass	6 (8.3%)
Total ischemia time (min)	435 (390-488)

HCC: Hepatocellular carcinoma; MELD: Model for end-stage liver disease.

Table 2 T-tube management in the study population

Variable	Study population n = 72, median (IQR)/n
Time to removal of T-tube (d)	158 (128-206)
T-tube cholangiogram before removal	25 (35%)
Nelaton drain successful insertion	68 (94%)
Nelaton drain with bile output	18 (25%)
Time to removal of Nelaton drain	2 (2-4)
Active treatment required
ERCP	6 (8%)
Hepatico-jejunostomy	1 (1%)
Emergency surgery	0

ERCP: Endoscopic retrograde cholangiopancreatography.

Table 3 Summary of events and treatment required in the study population after T-tube removal

	Events	First-line treatment	Definitive treatment
Accidental T-tube removal	4	4 monitoring
Post T-tube removal bile leak
Controlled fistula (through Nelaton drain)	18	15 onitoring	-
		3 ERCP	2 stent; 1 HJ
Biliary peritonitis	3 suspected	3 ERCP (1 confirmed)	3 NBD

ERCP: Endoscopic retrograde cholangiopancreatography; HJ: Hepatico-jejunostomy; NBD: Naso-biliary drain.