Pediatric Liver Transplantation Secondary to Hepatoblastoma without the Use of a Kehr’s T Tube

Abstract

Hepatoblastoma has a PRETEXT staging depending on the degree of hepatic involvement; stage IV is an indication for transplantation. At the same time, it has sought to reduce the occurrence of posttransplant complications by not using a Kehr’s T tube during the choledocho-choledochostomy, obtaining interesting results. A 16-month-old girl diagnosed with a PRETEXT IV hepatoblastoma, who received four courses of chemotherapy (CTX) with cisplatin plus doxorubicin, after she received a liver transplant and during surgery it was decided not to use a Kehr T-tube. She remained stable and had a favorable evolution, leaving on day 19 posttransplant. One month later, she received two cycles of adjuvant CTX with CAV scheme. Currently, she is free of disease. Even though the technique of choice is hepaticojejunostomy, it was decided to perform a choledocho-choledochostomy without a Kehr’s T tube, without the development of complications. Results in the literature show that the use of this technique prevents the appearance of complications in up to half of the cases, compared to when the tube is used.