Tsui, Tung Yu and Schlitt, Hans Juergen and Obed, Aiman (2011) Prospective evaluation of biliary reconstruction with duct-to-duct continuous suture in adult live donor liver transplantation. LANGENBECKS ARCHIVES OF SURGERY, 396 (2). pp. 209-215. ISSN 1435-2443,
Full text not available from this repository. (Request a copy)Abstract
Biliary reconstruction remains the Achilles' heel of adult live donor liver transplantation (LDLT). The study aims to investigate the feasibility of duct-to-duct hepaticocholedochostomy in LDLT. Perioperative data from 30 consecutive LDLT aiming at duct-to-duct reconstruction of the biliary tract using a continuous suture technique were prospectively collected. Nineteen recipients (63.3%) had one graft bile duct. Eleven recipients (36.7%) had two or three graft bile ducts. The median follow-up was 50 months. The overall biliary complication rate was 23.3%. Two recipients developed biliary stricture (6.7%), and two recipients (6.7%) presented with biliary leakage in early posttransplant phase (< 90 days). One recipient suffered from bilioma (3.3%), and two recipients (6.7%) presented with biliary stricture in later posttransplant phase (> 90 days). No correlation was found between the number of graft bile ducts and the incidence of biliary complications. No biliary complication-associated necessity for re-transplantation or mortality was observed. On multivariate analysis, no single risk factor associated with biliary complication could be identified. All biliary complications were successfully treated with Roux-en-hepaticojejunostomy and/or with endoscopic interventions. Duct-to-duct hepaticocholedochostomy with continues suture represents a safe and feasible procedure for biliary reconstruction in LDLT. Recipients may benefit from aggressive management of biliary complications with Roux-en-hepaticojejunostomy as compared with repeated endoscopic interventions in early posttransplant phase.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RIGHT LOBE GRAFT; COMPLICATIONS; DRAINAGE; Live donor liver transplantation; Biliary reconstruction; Duct-to-duct continues suture; Biliary complication |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 26 Jun 2020 09:40 |
| Last Modified: | 26 Jun 2020 09:40 |
| URI: | https://pred.uni-regensburg.de/id/eprint/21332 |
Actions (login required)
 |
View Item |
