Laparoscopic surgery after orthotopic liver transplantation |
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| Affiliation: | 1. Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;2. McKenna EpiLog Fellowship in Population Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA;3. West Chester University, The West Chester Statistical Institute and Department of Mathematics, West Chester, Pennsylvania, USA;1. Department of Cardiothoracic Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri;2. Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri;3. Department of Public Health, Temple University, Philadelphia, Pennsylvania;4. Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut;1. Department of Pediatrics, Ohio State University College of Medicine, Columbus, Ohio;2. Department of Internal Medicine, Ohio State University College of Medicine, Columbus, Ohio;3. Department of Surgery, Ohio State University College of Medicine, Columbus, Ohio;4. Department of Anesthesiology, Ohio State University College of Medicine, Columbus, Ohio;5. Section of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, Ohio;6. Department of Cardiothoracic Surgery, Nationwide Children’s Hospital, Columbus, Ohio;7. Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, Ohio;1. Division of Cardiothoracic Surgery, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia;2. Department of Pediatrics, Division of Cardiology, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia;1. Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland;2. Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland;3. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland;4. Division of Pediatric Cardiology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland |
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| Abstract: | Laparoscopic surgery is currently a widely accepted approach to several surgical fields because of its advantages in terms of postoperative pain reduction and easy patient recovery. This approach may be useful even in solid-organ transplantation surgery as a diagnostic or treatment procedure in some surgical complications. From July 1991 to December 1998, we performed 142 liver transplantations on 129 patients. During the postoperative period, many complications occurred. Here we report two cases of intestinal occlusion caused by adhesions and three cases of lymphocele, all approached with laparoscopic surgery. In all cases but one, we were able to complete the surgery by laparoscopic means; in one of the two occlusions, the procedure was switched to laparotomy because of a choledochojejunal anastomosis lesion. The three cases of lymphocele must be considered in a particular manner because such cases, to our knowledge, have never been described in the literature. They always presented with a late-onset right pleural effusion and were located in the retrohepatic, retrogastric, and left paracaval areas, close to the esophageal hiatus. In conclusion, we believe a laparoscopic approach is a useful strategy to solve some surgical complications in patients who underwent orthotopic liver transplantation; however, the use of laparoscopic surgery in this field is strictly connected to the surgeon's experience and versatility. |
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