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Verfasst von:Gotthardt, Daniel [VerfasserIn]   i
 Weiss, Karl Heinz [VerfasserIn]   i
 Rupp, Christian [VerfasserIn]   i
 Bode, Konrad A. [VerfasserIn]   i
 Eckerle, Isabella [VerfasserIn]   i
 Rudolph, Gerda [VerfasserIn]   i
 Bergemann, Janine [VerfasserIn]   i
 Klöters-Plachky, Petra [VerfasserIn]   i
 Chahoud, Fadi [VerfasserIn]   i
 Büchler, Markus W. [VerfasserIn]   i
 Schemmer, Peter [VerfasserIn]   i
 Stremmel, Wolfgang [VerfasserIn]   i
 Sauer, Peter [VerfasserIn]   i
Titel:Bacteriobilia and fungibilia are associated with outcome in patients with endoscopic treatment of biliary complications after liver transplantation
Verf.angabe:Daniel N Gotthardt, Karl Heinz Weiss, Christian Rupp, Konrad Bode, Isabella Eckerle, Gerda Rudolph, Janine Bergemann, Petra Kloeters-Plachky, Fadi Chahoud, Markus W Büchler, Peter Schemmer, Wolfgang Stremmel, Peter Sauer
E-Jahr:2013
Jahr:28. Oktober 2013
Umfang:7 S.
Fussnoten:Gesehen am 19.02.2020
Titel Quelle:Enthalten in: Endoscopy
Ort Quelle:Stuttgart [u.a.] : Thieme, 1969
Jahr Quelle:2013
Band/Heft Quelle:45(2013), 11, Seite 890-896
ISSN Quelle:1438-8812
Abstract:<p> <b>Background and study aims:</b> To determine the importance of bacteriobilia and fungibilia in patients with endoscopic treatment of biliary complications after orthotopic liver transplantation (OLT).</p> <p> <b>Patients and methods:</b> In a prospective study at a tertiary center, 213 patients underwent 857 endoscopic retrograde cholangiographies (ERCs) after OLT. Findings at first ERC were: anastomotic stricture in 24.4 %, nonanastomotic stricture in 18.3 %, leakage in 11.3 %, and gallstones in 4.7 %.</p> <p> <b>Results:</b> Bile samples from first ERC showed Gram-positive bacterial isolates in 102/180 (57 %) and Gram-negative in 44/180 (24 %). Main species were <i>Enterococcus </i>spp<i>.</i> (40 %; 72/180) and <i>Escherichia</i> <i>coli</i> (10 %; 18 /180). Enteric bacteria (present in 47 %) and <i>Candida </i>spp<i>. </i>(present in 18 %) were both associated with clinical signs of cholangitis, but not with laboratory signs of inflammation. Multiresistant strains (present in12 % of samples) showed no association with clinical or laboratory parameters. Detection of microbiological isolates was independent of endoscopic findings and treatment. In patients with successful endoscopic intervention, the actuarial survival free of retransplantation was significantly lower in those with detection of enteric bacteria, being 51.8 months (95 % confidence interval [CI] 42.9 - 60.6) vs. 62.9 months (95 %CI 59.1 - 66.7); <i>P</i> = 0.025). Fungibilia was associated with significantly lower actuarial retransplantation-free survival, independently of successful endoscopic treatment (mean 35.1 months [95 %CI 23.5 - 46.7] vs. 53.1 months [(95 %CI 48.0 - 58.2]; <i>P</i> = 0.019).</p> <p> <b>Conclusions:</b> Bacteriobilia and fungibilia can frequently be detected by routine microbiological sampling in patients after OLT. Regular bile sampling is recommended since the presence of difficult-to-treat multiresistant strains is unpredictable. Survival is affected by this altered biliary microbiological environment after OLT.</p>
DOI:doi:10.1055/s-0033-1344713
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: https://doi.org/10.1055/s-0033-1344713
 Volltext: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1344713
 DOI: https://doi.org/10.1055/s-0033-1344713
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1748702432
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