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Background/aims: Biliary tract complications constitute a common cause of post-operative morbidity after orthotopic liver transplantation. Bile leakage following T-tube removal, even if uncommon, can also seriously influence post-operative recovery. This report outlines the diagnostic and therapeutic policy used to treat this complication in a large liver transplantation center., Methodology: Fourteen consecutive cases of bile leakage after T-tube removal are presented. Abdominal pain was the most common symptom and acute abdomen developed in one third of the patients. Ultrasonography was the most common imaging technique used., Results: Five patients were treated conservatively with or without percutaneous drainage of the biloma and 9 patients underwent an exploratory laparotomy. Ligation of the T-tube tract was the most common technique used. All patients had an uneventful clinical course., Conclusions: Clinical signs are the most important factor in the diagnosis of this complication, and should be treated surgically if the patient does not improve within 24-48 hours under conservative management. Inadequate fibrous T-tube tract formation due to immunosuppression or the underlying disease could be an explanation for the development of this complication.

Administration of ambilhar or its N-acetyl derivative to rabbits resulted in a significant increase in urinary iron excretion, due to chelation. Substitution of the sulphur of thiazole by nitrogen abolished its metal chelating power. In vitro three different iron chelates were obtained, containing one or two iron atoms per mole of drug. However, in vivo studies revealed the presence of an ambilhar iron complex in which 6 molecules of the drug were chelated with one iron atom. Reduction is an important factor in the process of metal chelation by the thiazole sulphur of the drug.