Biliary complications in adult living donor liver transplantation with duct-to-duct hepaticocholedochostomy or Roux-en-Y hepaticojejunostomy biliary reconstruction

Kawa, Shigeyuki; Shimazu, Motohide; Wakabayashi, Go; Hoshino, Ken; Tanabe, Minoru; Yoshida, Masashi; Morikawa, Yasuhide; Kitajima, Masaki

doi:10.1067/msy.2002.125314

Cited by 103 publications

(88 citation statements)

References 19 publications

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“…Hepaticojejunostomy remains the method of choice for biliary reconstruction in the left lateral segment split liver grafts, as well as in a left lateral segment or left lobe living-donor grafts [39,41,42,43, 49, 50]. However, duct-to-duct anastomosis in left lobe living-donor liver transplants has also been shown to be feasible [51, 52]. …”

Section: Biliary Reconstruction At Liver Transplantationmentioning

confidence: 99%

Biliary Tract Complications after Liver Transplantation: A Review

Wójcicki¹,

Milkiewicz²,

2008

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Biliary complications continue to be a major cause of morbidity in liver transplant recipients with an incidence of 10–30% following whole-organ transplantation and a mortality rate of up to 10%. Biliary leaks and strictures are most common but sphincter of Oddi dysfunction, hemobilia, and biliary obstruction are also observed. Biliary complications may be related to various factors such as hepatic artery patency, preservation injury, cytomegalovirus infection, chronic ductopenic rejection, ABO incompatibility, and technical reasons. The latter include imperfect anastomosis, T-tube-related complications and the use of partial liver grafts when cut surface biliary leaks or inadvertent bile duct injuries may occur during parenchymal division. The usage of a T-tube for duct-to-duct anastomosis in whole-organ liver transplantation remains controversial, mainly because of the high rates of T-tube-related complications observed in many series. In this article we review the etiology, as well as the main types of biliary complications according to the technique of biliary reconstruction and liver transplant procedure performed. Their management is also discussed with interventional radiology and endoscopic techniques emerging as the preferred treatment option, obviating the need for surgery in a selected majority of patients.

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Section: Biliary Reconstruction At Liver Transplantationmentioning

confidence: 99%

Biliary Tract Complications after Liver Transplantation: A Review

Wójcicki¹,

Milkiewicz²,

2008

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“…In LDLT patients, anastomotic stricture, duct-to-duct or duct-to-GI tract, is the most common and problematic adverse events up to 30%. 8,9 There are several interventions including re-operation, interventional radiology, and endoscopic therapy to resolve the tough stricture.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Compression Duct-to-duct Anastomosis for Biliary Obstruction in a Patient with Living Donor Liver Transplantation

Itoi

Yamanouchi²,

Ikeuchi³

et al. 2010

Gut Liver

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Magnetic compression anastomosis (MCA) is a minimally invasive method of performing choledochocholedochostomy without surgery in patients with biliary stricture or obstruction. We describe a successful case involving magnetic compression duct-to-duct biliary reconstruction in right-lobe living donor liver transplantation (RL-LDLT). Endoscopically, a samarium-cobalt (SmCo) rare-earth magnet was placed at the superior site of obstruction via the percutaneous transhepatic biliary drainage route, and another Sm-Co magnet was also placed at the inferior site of obstruction with the aid of an endoscope. MCA techniques enabled complete anastomosis without procedure-related complications.In conclusion, the MCA technique is a revolutionary method of performing choledochocholedochostomy in patients with biliary obstruction after LDLT. (Gut Liver 2010;4(Suppl. 1):S96-98)

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“…O ducto hepático esquerdo é mais longo que o direito e menos sujeito a malformações, e em 90% dos casos de doação de lobos hepáticos esquerdos e segmentos laterais esquerdos, um orifício único para reconstrução pode ser obtido (15) . No presente estudo, uma via biliar única foi obtida nos oito casos de captação de segmento lateral esquerdo ou do lobo hepático esquerdo.…”

Section: Discussionunclassified

“…Desta forma, é importante a preservação do plexo periductal no procedimento de doação com secção dos ductos biliares próximos à superfície hepática. Na cirurgia do receptor, deve se ter atenção para não haver lesão dos plexos arteriais, derivados da artéria gastroduodenal e da artéria hepática direita (15) . Conclui-se que a prevalência das anomalias nas vias biliares é elevada nos transplantes inter vivos de fígado e que algumas anomalias não são diagnosticadas nos exames de imagem pré-operatórios.…”

Section: Discussionunclassified

Anatomia das vias biliares em doadores e receptores de transplante hepático inter vivos

Soares

Coelho

Matias

et al. 2006

Arq. Gastroenterol.

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RESUMOResultados -Nas cirurgias de captação do lobo hepático direito, a via biliar direita foi única em 25 entre 29 casos (86,2%), dupla em dois (6,9%) e tripla em dois (6,9%). Nos oito casos em que o setor lateral esquerdo ou o lobo hepático esquerdo foram captados, a via biliar foi única. Entre os 33 pacientes submetidos a colangiografi a por ressonância magnética, variações foram verifi cadas em três pacientes (9,1%), sendo a mais comum o ducto biliar posterior direito tributário do ducto hepático esquerdo (6,06%; n = 2). Conclusão -A prevalência de anomalias biliares nos transplantes inter vivos de fígado é elevada e algumas não são diagnosticadas com os exames de imagem pré-operatórios.

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Biliary complications in adult living donor liver transplantation with duct-to-duct hepaticocholedochostomy or Roux-en-Y hepaticojejunostomy biliary reconstruction

Cited by 103 publications

References 19 publications

Biliary Tract Complications after Liver Transplantation: A Review

Biliary Tract Complications after Liver Transplantation: A Review

Magnetic Compression Duct-to-duct Anastomosis for Biliary Obstruction in a Patient with Living Donor Liver Transplantation

Anatomia das vias biliares em doadores e receptores de transplante hepático inter vivos

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