PURPOSE: Biliary complications (BC) after living donor liver transplantation (LDLT) are reported in up to 32%. We retrospectively reviewed the biliary reconstruction after 95 LDLT. METHODS: Eighty-one right hemiliver grafts and 14 left lateral section grafts were transplanted. Bile duct anastomoses were performed as duct-to-duct (DD) or bilioenteric anastomosis (RYHJ); multiple bile ducts were anastomosed using a ductoplasty or multiple direct bile duct anastomoses. RESULTS: After right hemiliver LDLT, a total of 45.5% of BC was observed, with an incidence of 27.7% in case of DD anastomosis and 18.8% in case of RYHJ. After DD anastomosis, strictures were successfully treated endoscopically in 50%; insufficiencies mainly required reoperations. CONCLUSION: BC still account for a high percentage of morbidity and mortality after LDLT. DD anastomoses are performed more frequently and are feasible in cases with simple biliary anatomy; RYHJ is the gold standard for the reconstruction of multiple bile ducts.
PURPOSE: Biliary complications (BC) after living donor liver transplantation (LDLT) are reported in up to 32%. We retrospectively reviewed the biliary reconstruction after 95 LDLT. METHODS: Eighty-one right hemiliver grafts and 14 left lateral section grafts were transplanted. Bile duct anastomoses were performed as duct-to-duct (DD) or bilioenteric anastomosis (RYHJ); multiple bile ducts were anastomosed using a ductoplasty or multiple direct bile duct anastomoses. RESULTS: After right hemiliver LDLT, a total of 45.5% of BC was observed, with an incidence of 27.7% in case of DD anastomosis and 18.8% in case of RYHJ. After DD anastomosis, strictures were successfully treated endoscopically in 50%; insufficiencies mainly required reoperations. CONCLUSION:BC still account for a high percentage of morbidity and mortality after LDLT. DD anastomoses are performed more frequently and are feasible in cases with simple biliary anatomy; RYHJ is the gold standard for the reconstruction of multiple bile ducts.
Authors: P R Pfau; M L Kochman; J D Lewis; W B Long; M R Lucey; K Olthoff; A Shaked; G G Ginsberg Journal: Gastrointest Endosc Date: 2000-07 Impact factor: 9.427
Authors: S Kawasaki; M Makuuchi; H Matsunami; Y Hashikura; T Ikegami; Y Nakazawa; H Chisuwa; M Terada; S Miyagawa Journal: Ann Surg Date: 1998-02 Impact factor: 12.969
Authors: Michael A Zimmerman; Talia Baker; Nathan P Goodrich; Chris Freise; Johnny C Hong; Sean Kumer; Peter Abt; Adrian H Cotterell; Benjamin Samstein; James E Everhart; Robert M Merion Journal: Liver Transpl Date: 2013-03 Impact factor: 5.799