The study of anastomoses in liver transplantation represents a complex and special subject considering the fact that a variability of methods have been described since the first liver transplant in 1963, made by Thomas Starzl. In liver transplantation, graft implantation includes 4 anastomoses: cavo-cava, portal, arterial and biliary. The Gordon patch represents the plasty performed between the aortic patch of the celiac trunk and the aortic patch of the superior mesenteric artery. It only applies to anatomical variants of the hepatic artery, namely when the common hepatic artery arises from the celiac trunk and the right hepatic artery arises from superior mesenteric artery. The present article describes the aspect of the surgical techniques through the experience at the Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest, Romania.

Background: A grade C postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) usually requires early re-laparotomy, and completion of pancreatectomy (CP) is necessary for a few patients. The study aims to assess the frequency, indications, and outcomes of CP in a single-center experience during the last 5 years. Methods:The data of all PD performed in our center between October 1st, 2016, and October 1st, 2021, were retrospectively extracted from a prospectively gathered electronic database. The data of patients requiring CP were analyzed for frequency, indications, and outcomes. Results: During the analyzed time, 363 PD were performed. A number of 26 patients (7.2%) developed a grade C POPF. CP for postoperative complications was performed in 15 patients (4.1%). Furthermore, 57.7% of patients with a grade C POPF required a CP. The indications for CP were grade C POPF with associated grade C hemorrhage and postoperative pancreatitis in all patients. In the group of patients with CP, the mortality rate was 66.6% (10 patients). Conclusions: Although CP is rarely required to treat postoperative complications after PD, it is associated with very high mortality rates. CP should be reserved only for highly selected patients, while pancreas-preserving alternative procedures should be considered to improve mortality rates.

Sécurité du donneur dans la transplantation hépatique à partir d'un donneur vivant: expérience de deux centres médicaux en Roumanie et en République de MoldovaIntroduction. La transplantation hépatique à partir d'un donneur vivant (THDV) est devenue une modalité de traitement réalisable pour les maladies hépatiques en phase terminale. L'objectif de l'étude a été d'evaluer la sécurité des donneurs dans le cadre de la THDV. Matériel et méthodes. La présente étude a évalué la sécurité des donneurs dans le cadre de la THDV à partir de 157 procédures réalisées par deux centres de transplantation: Bucarest (Roumanie) et Chisinau (République de Moldova). Nous avons examiné les données des donneurs vivants de foie (DV) qui ont subi des procédures entre 2000 et 2020. Les résultats ont

In the 1990s a sampling team from the Surgery Department of Saint Luc Clinic in Louvain Brussels, published a study showing that single aortic infusion is as safe as classic, standard infusion (aortic and portal) but the attempt was not fully accepted. Also, some recent studies recommend the safe use of single aortic infusions in the case of multiple organ sampling from the brain-dead donor. In order to test the effectiveness of this method we made a retrospective study between 2017 and 2019 at the Center for General Surgery and Liver Transplantation of the Fundeni Clinical Institute, Bucharest, Romania. First of all, we performed a comparative analysis between the single aortic sampling group and the group in which we used the standard sampling. We also analyzed the impact of singular aortic sampling on cases with anatomical arterial variants.