J Korean Soc Transplant.  2016 Dec;30(4):172-177. 10.4285/jkstn.2016.30.4.172.

The Role of Bile Duct Probe for Bile Duct Division during Donor Right Hemihepatectomy

• Bae SJ
• Han DH
• Choi GH
• Choi JS

• KMID: 2364937
• DOI: http://doi.org/10.4285/jkstn.2016.30.4.172

Abstract

BACKGROUND
To prevent bile duct related complications, exact division of donor bile duct is essential, not only for the recipient, but also for the donor during living donor liver transplantation. Cholangiography has been used for bile duct division during living donor right hemihepatectomy. This study was conducted to determine if bile duct probe could be used to replace cholangiography for bile duct division during living donor right hemihepatectomy.
METHODS
Surgical outcomes of 234 donors with right hemihepatectomy and duct to duct biliary anastomosis in living donor liver transplantation between January 2009 and December 2014 were retrospectively analyzed. A total of 85 donors used the bile duct probe for bile duct division during the right hemihepatectomy, whereas 149 donors used cholangiography. All donors underwent preoperative magnetic resonance cholangiopancreatography (MRCP).
RESULTS
The expected number of bile duct orifices based on MRCP did not differ significantly from the observed number of bile duct orifices after bile duct division (10 donors and five donors in each group were mismatched, P=0.238). The operation time was 384.7 minutes in the probe group, which was significantly shorter than that of the cholangiography group (400.4 minutes, P=0.041).
CONCLUSIONS
Bile duct probing without intraoperative cholangiography might be a feasible procedure for bile duct division during living donor hemihepatectomy.

Keyword

Liver transplantation; Bile ducts; Anastomosis; Probe; Postoperative complications

MeSH Terms

Bile Ducts*
Bile*
Cholangiography
Cholangiopancreatography, Magnetic Resonance
Humans
Liver Transplantation
Living Donors
Postoperative Complications
Retrospective Studies
Tissue Donors*

Figure

• 

  Fig. 1. (A) Intraoperative view and (B) schematic view of bile duct probing method during donor right hemihepatectomy. The operator can decide the resection plan by tactile sensation under the direct vision using probing method.

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