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In adult-to-adult living donor liver transplantation hepaticojejunostomy shows a better long-term outcome than duct-to-duct anastomosis
Cited 27 time in
Web of Science
Cited 28 time in Scopus
- Authors
- Issue Date
- 2005-10-14
- Publisher
- Blackwell Publishing
- Citation
- Transpl Int. 2005 Nov;18(11):1240-7
- Keywords
- Adult ; Anastomosis, Roux-en-Y ; Bile Ducts/*surgery ; Biliary Tract Surgical Procedures ; Cholestasis/*epidemiology ; Female ; Humans ; Incidence ; Jejunum/*surgery ; Liver Transplantation/*methods/statistics & numerical data ; Male ; Middle Aged ; Postoperative Complications/*epidemiology ; Retrospective Studies ; Stents ; Treatment Outcome ; Living Donors
- Abstract
- Roux-en-Y hepaticojejunostomy (RYHJ) has been the standard biliary reconstruction in adult-to-adult living donor liver transplantation (ALDLT). Recently, duct-to-duct anastomosis (DD) has been introduced. This study compared the outcomes of RYHJ and DD. For 4 years, 74 recipients underwent ALDLT and were followed up for at least 2 years. The patients were divided into three groups, RYHJ group (n = 18), DD with a stent (DD + S) group (n = 35), and DD without a stent (DD - S) group (n = 21). Overall, biliary complications were developed in 32.4% patients. The biliary complication rate was 11.1%, 48.5% and 33.3% in RYHJ, DD + S and DD - S groups, respectively (P = 0.047). Bile leaks occurred in 28.5% of DD + S group. The incidence of biliary stricture was 5.3%, 20.2% and 28.6% in RYHJ, DD + S and DD - S group, respectively. Most complications (83.3%) were resolved nonsurgically. RYHJ has a better long-term outcome than DD in ALDLT. Subgroup analysis of DD group showed that DD - S group had no bile leaks, but still had a higher incidence of bile duct strictures. However, because this study was a retrospective review there are limitations in analyzing the data and confirming the conclusion. A randomized-prospective study will be needed to confirm these findings.
- ISSN
- 0934-0874 (Print)
- Language
- English
- URI
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16221154
https://hdl.handle.net/10371/15857
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