Background : External bile stents may be performed with a preference for each transplant center in order to prevent these biliary complications. However, the external biliary stent itself has a risk of complication. This study evaluated the frequency and treatment of complications a8ssociated with external bile stent.

Methods : 43 patients who underwent LT between 2015 and 2019, their medical records were retrospectively analyzed. We performed insertion of external bile stent as a routine procedure. Evaluated factors included demographic profile, type of transplantation and presence of vascular and biliary complications, external bile stent-related complications, their treatment, and results.

Results : 18 deceased donor liver transplantations (DDLTs) and 25 living donor liver transplantations (LDLTs) were performed. Biliary complications occurred in 12 patients (27.9%); three strictures (6.9%), two leakages (4.6%) and five external bile stent-related complications (16.2%). Among the five, three were self-removal or stent fracture at home, one local peritonitis after removal by a doctor, the other local peritonitis with ileus. local peritonitis was treated by antibiotics and fluid therapy but one patient with recurrent local peritonitis had an operation due to intestinal obstruction. Interestingly, all of the biliary complications had occurred in LDLT, and external biliary stent-related complications also had occurred only in LDLT, not in DDLT. (p=0.014)

Conclusions : The incidence of external bile stent-related complications was higher in LDLT than that of DDLT. Especially in LDLT, we need to consider the advantages and disadvantages of external bile stent when performing external bile stent implantation.