OBJECTIVE: To justify the technique of biliary reconstruction without mucosa-to-mucosa alignment for reconstructing the caudate lobe bile duct. SUMMARY BACKGROUND DATA: The use of a left hepatic lobe graft with the caudate lobe (LHGC) has been introduced to resolve the problem of small-for-size grafts in living-related liver transplantation. The authors have found that the LHGCs occasionally have independent openings of the bile duct of the caudate lobe. METHODS: The graft bile ducts were anastomosed to Roux-en-Y jejunal loops. The main left hepatic ducts were reconstructed in a standard manner. Small bile ducts of the caudate lobe were anastomosed to the intestine without mucosa-to-mucosa alignment, with an external biliary drainage tube, positioned transanastomotically. RESULTS: In 8 of the 19 patients who received LHGCs, nine bile ducts of the caudate lobe (median 1 mm) were reconstructed. After surgery there was no bile leakage. In five of the eight patients, the tubes were removed a median of 92 days after transplantation. Bile duct dilatation had not been observed at a median of 363 days after surgery. CONCLUSIONS: The authors consider their technique of biliary reconstruction without mucosa-to-mucosa alignment useful for the safe reconstruction of small bile ducts of the caudate lobe.
OBJECTIVE: To justify the technique of biliary reconstruction without mucosa-to-mucosa alignment for reconstructing the caudate lobe bile duct. SUMMARY BACKGROUND DATA: The use of a left hepatic lobe graft with the caudate lobe (LHGC) has been introduced to resolve the problem of small-for-size grafts in living-related liver transplantation. The authors have found that the LHGCs occasionally have independent openings of the bile duct of the caudate lobe. METHODS: The graft bile ducts were anastomosed to Roux-en-Y jejunal loops. The main left hepatic ducts were reconstructed in a standard manner. Small bile ducts of the caudate lobe were anastomosed to the intestine without mucosa-to-mucosa alignment, with an external biliary drainage tube, positioned transanastomotically. RESULTS: In 8 of the 19 patients who received LHGCs, nine bile ducts of the caudate lobe (median 1 mm) were reconstructed. After surgery there was no bile leakage. In five of the eight patients, the tubes were removed a median of 92 days after transplantation. Bile duct dilatation had not been observed at a median of 363 days after surgery. CONCLUSIONS: The authors consider their technique of biliary reconstruction without mucosa-to-mucosa alignment useful for the safe reconstruction of small bile ducts of the caudate lobe.
Authors: Y Inomata; T Kiuchi; I Kim; S Uemoto; H Egawa; K Asonuma; S Fujita; M Hayashi; K Tanaka Journal: Transplantation Date: 1999-05-27 Impact factor: 4.939
Authors: S Miyagawa; Y Hashikura; S Miwa; T Ikegami; K Urata; M Terada; T Kubota; T Nakata; S Kawasaki Journal: Transplantation Date: 1998-09-15 Impact factor: 4.939
Authors: A Marcos; R A Fisher; J M Ham; M L Shiffman; A J Sanyal; V A Luketic; R K Sterling; M P Posner Journal: Transplantation Date: 1999-09-27 Impact factor: 4.939
Authors: T Benkö; G Sgourakis; E P Molmenti; H O Peitgen; A Paul; S Nadalin; T Schroeder; A Radtke Journal: World J Surg Date: 2017-03 Impact factor: 3.352