T-tube Systematic Use in the Biliary Anastomosis: Comparison of Two Consecutive Series of Liver Transplantation.

OBJECTIVES: The authors sought to check the frequency of biliary complications with the use of a T-tube. In 2012, throughout the year, it was carried out systematically in all liver transplantations regardless of the characteristics of the bile duct. Despite the long experience, biliary complications remain a common cause of postoperative morbidity and mortality. MATERIAL AND METHODS: In this study we compared complications in 23 consecutive transplantation cases using T-tube biliary anastomosis during the year 2012 with 23 consecutive transplantation cases without T-tube during the year 2013. We evaluated postoperative complications and long-term outcomes (for 2 years to 3 years). RESULTS: Of the 23 patients with anastomosis with a T-tube, 2 patients (8.69%) had biliary stricture that required prosthesis by endoscopic retrograde cholangiopancreatography, 1 of them (4.34%) was operated by incorrect placement of the T-tube, and in 4 patients (17.39%) bile leakage (endoscopic retrograde cholangiopancreatography prostheses in 3 cases and hepaticojejunostomy in 1). During follow-up at 3 years, only 2 patients had minimal bile duct dilatation without clinical relevance. In the patients who underwent transplantation without a T-tube, 18 (78.26%) had no complications, 3 (13.04%) showed stenosis (prosthesis placement), and 2 (8.69%) had bile leakage (hepaticojejunostomy and prosthesis). During follow-up at 2 years to 3 years, no patient had biliary dilatation or alteration of cholestatic parameters. In the comparative study of both groups we found no statistically significant differences. CONCLUSIONS: We have not seen an improvement in complications with the use of T-tube (69.56% vs. 78.23%) that encourage us to work systematically, although the small number of cases does not allow statistically significant conclusions.

Indicaciones y limitaciones de la cirugía del carcinoma de páncreas / No disponible

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Paraganglioma no cromafin del retroperineo y linfoma no hodgkiniano, una rara asociación / Nonchromafflin paranglioma of the retroperitoneum and non-Hodking lymphoma, a strange association

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Effect of streptozotocin-induced diabetes and islet transplantation in proximal skeletal muscle: a histochemical and morphometric analysis.

The effect of pancreatic islet transplantation on the development of diabetic myopathy in streptozotocin-induced diabetic Lewis rats was examined histochemically and morphometrically in a proximal striated (rectus femoris) muscle. Diabetes was induced by streptozotocin administration, and diabetic animals were transplanted by intraportal grafts 6 weeks later. Islet-transplanted rats returned to euglycemia usually within the first 24 hours after transplantation and remained euglycemic over the subsequent 12-week observation period. Transplanted animals were compared with age-matched nontransplanted diabetic rats and nondiabetic age-matched control rats. Successful isotransplantation completely prevented the characteristic fast twitch (type IIB, glycolytic) fiber atrophy and also the changes in the fiber-type relative percentages, with prevention of the significant increase in the frequency of slow twitch oxidative (type I) and fast oxidative/glycolytic (type IIA) fibers at the expense of fast twitch glycolytic (type IIB) fibers. The histochemical appearance of all fiber types studied from muscles in transplanted rats was identical to equivalent fibers in age-matched control rats. Our data suggest that diabetic muscle pathology could be reversed and the progression of diabetic amyotrophy halted through the restoration of a euglycemic state by successful pancreatic islet transplantation, at least in short-term experimental diabetes.