{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T19:55:48Z","timestamp":1772481348882,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,1,20]],"date-time":"2016-01-20T00:00:00Z","timestamp":1453248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Massive bleeding during liver transplantation (LT) is difficult to manage surgical event. Perihepatic packing (PP) and temporary abdominal closure (TAC) with delayed biliary reconstruction (DBR) can be applied in these circumstances.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A prospective database of LT in a major transplant center was analyzed to identify patients with massive uncontrollable bleeding during LT that was resolved by PP, TAC, and DBR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From <jats:styled-content style=\"fixed-case\"><jats:styled-content>January<\/jats:styled-content><\/jats:styled-content> 2009 to <jats:styled-content style=\"fixed-case\"><jats:styled-content>July<\/jats:styled-content><\/jats:styled-content> 2013, 20 (3.6%) of 547 patients who underwent LT underwent DBR. Mean intraoperative blood loss was 20,500\u00a0ml at the first operation. The DBR was performed with a mean of 55.2\u00a0h (16\u2013110) after LT. Biliary reconstruction included duct\u2010to\u2010duct (<jats:italic>n<\/jats:italic>\u00a0=\u00a09) and hepatico\u2010jejunostomy (<jats:italic>n<\/jats:italic>\u00a0=\u00a011). Complications occurred in eight patients and included portal vein thrombosis, cholangitis, severe bacteremia, pneumonia. There was one in\u2010hospital death. In the follow\u2010up of 18 to 33\u00a0months we have seen one patient died 9\u00a0months after transplantation. The remaining 18 patients are alive and well.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In case of massive uncontrollable bleeding and bowel edema during LT, the combined procedures of PP, TAC, and DBR offer an alternatively surgical option to solve the tough situation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.311","type":"journal-article","created":{"date-parts":[[2015,12,22]],"date-time":"2015-12-22T06:12:27Z","timestamp":1450764747000},"page":"118-124","source":"Crossref","is-referenced-by-count":13,"title":["Temporary abdominal closure and delayed biliary reconstruction due to massive bleeding in patients undergoing liver transplantation: an old trick in a new indication"],"prefix":"10.1002","volume":"23","author":[{"given":"Andrzej L.","family":"Komorowski","sequence":"first","affiliation":[{"name":"Liver Transplantation Program and Department of Surgery Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine  123 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Hospital, Chang Gung University College of Medicine  123 Ta\u2010Pei Road, Niao\u2010Song Kaohsiung 833 Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting\u2010Lung","family":"Lin","sequence":"additional","affiliation":[{"name":"Liver Transplantation Program and Department of Surgery Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine  123 Ta\u2010Pei Road, Niao\u2010Song Kaohsiung 833 Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Jawan","sequence":"additional","affiliation":[{"name":"Liver Transplantation Program and Department of Anesthesiology Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih\u2010Chi","family":"Wang","sequence":"additional","affiliation":[{"name":"Liver Transplantation Program and Department of Surgery Kaohsiung Chang Gung Memorial Hospital, Chang 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