RT Journal Article
SR Electronic
T1 Novel Biliary Reconstruction Techniques During Liver Transplantation
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 42
OP 45
VO 17
IS 1
A1 Ian C. Carmody
A1 John Romano
A1 Humberto Bohorquez
A1 Emily Bugeaud
A1 David S. Bruce
A1 Ari J. Cohen
A1 John Seal
A1 Trevor W. Reichman
A1 George E. Loss
YR 2017
UL http://www.ochsnerjournal.org/content/17/1/42.abstract
AB 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.