TY - JOUR T1 - Novel Biliary Reconstruction Techniques During Liver Transplantation JF - Ochsner Journal JO - Ochsner J SP - 42 LP - 45 VL - 17 IS - 1 AU - Ian C. Carmody AU - John Romano AU - Humberto Bohorquez AU - Emily Bugeaud AU - David S. Bruce AU - Ari J. Cohen AU - John Seal AU - Trevor W. Reichman AU - George E. Loss Y1 - 2017/03/20 UR - http://www.ochsnerjournal.org/content/17/1/42.abstract N2 - Background: Biliary complications remain a significant problem following liver transplantation. Several surgical options can be used to deal with a significant size mismatch between the donor and recipient bile ducts during the biliary anastomosis. We compared biliary transposition to recipient biliary ductoplasty in cadaveric liver transplant.Methods: A total of 33 reconstructions were performed from January 1, 2005 to December 31, 2013. In the biliary transposition group (n=23), 5 reconstructions were performed using an internal stent (5 or 8 French pediatric feeding tube), and 18 were performed without. Of the 10 biliary ductoplasties, 2 were performed with a stent. All patients were managed with standard immunosuppression and ursodiol. Follow-up ranged from 2 months to 5 years.Results: No patients in the biliary transposition group required reoperation; 1 patient had an internal stent removed for recurrent unexplained leukocytosis, and 2 patients required endoscopic retrograde cholangiography and stent placement for evidence of stricture. Three anastomotic leaks occurred in the biliary ductoplasty group, and 2 patients in the biliary ductoplasty group required reoperation for biliary complications.Conclusion: Our results indicate that biliary reconstruction can be performed with either biliary transposition or biliary ductoplasty. These techniques are particularly useful when a significant mismatch in diameter exists between the donor and recipient bile ducts. ER -