J Korean Soc Transplant.  2016 Mar;30(1):6-12. 10.4285/jkstn.2016.30.1.6.

Single Center Experience of Biliary Reconstruction in Living Donor Liver Transplantation: Duct-to-Duct Anastomosis

• Nam JH
• Yang SJ
• Lee JG
• Joo DJ
• Han DH
• Choi GH
• Choi JS

• KMID: 2202622
• DOI: http://doi.org/10.4285/jkstn.2016.30.1.6

Abstract

BACKGROUND
Duct-to-duct anastomosis is the most common biliary reconstruction method in living donor liver transplantation. However, biliary complications can frequently occur. The objective of this study was to examine biliary complications and related risk factors of patients with living donor liver transplantation during the last 12 years in our institution.
METHODS
Surgical outcomes of 252 consecutive patients with duct-to-duct anastomosis for biliary reconstruction in living donor liver transplantation between December 2000 and July 2012 were analyzed retrospectively.
RESULTS
Among the 252 patients, there were 65 cases (25.8%) of biliary complications. Before 2010, the incidence of biliary complications was 30.4% (56 of 184 cases). After 2011, the incidence was significantly (P<0.05) decreased to 13.2% (nine out of 68 cases). The complication rate of anastomosis of two separated bile ducts of graft to recipient two separated bile ducts using cystic duct and common bile duct of recipient was 50% (10 out of 20), which was relatively higher compared to that of single to single duct anastomosis (47 out of 191, 24.6%) or multiple duct to single duct anastomosis (eight out of 41, 19.5%).
CONCLUSIONS
Duct to duct anastomosis between two separated bile ducts of a graft to two separated bile ducts of a recipient, the most common biliary reconstruction method, was associated with higher rate of biliary complications. Complications related to biliary reconstruction of living donor liver transplantation was gradually decreased. Standardization of bile duct anastomosis might lead to sequential reduction of biliary complications in living donor liver transplantations.

Keyword

Liver transplantation; Bile ducts; Anastomosis; Postoperative complications

MeSH Terms

Bile Ducts
Common Bile Duct
Cystic Duct
Humans
Incidence
Liver Transplantation*
Liver*
Living Donors*
Postoperative Complications
Retrospective Studies
Risk Factors
Transplants

Figure

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  Fig. 1. Annual Incidence of living donor liver transplantation.

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  Fig. 2. Annual biliary complication after living donor liver transplantation.

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