S-Space College of Medicine/School of Medicine (의과대학/대학원) Surgery (외과학전공) Journal Papers (저널논문_외과학전공)
In adult-to-adult living donor liver transplantation hepaticojejunostomy shows a better long-term outcome than duct-to-duct anastomosis
- Yi, Nam-Joon; Suh, Kyung-Suk; Cho, Jai Young; Kwon, Choon Hyuck; Lee, Kuhn Uk
- Issue Date
- Blackwell Publishing
- Transpl Int. 2005 Nov;18(11):1240-7
- 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; *Living Donors; Male; Middle Aged; Postoperative Complications/*epidemiology; Retrospective Studies; Stents; Treatment Outcome
- 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.
- 0934-0874 (Print)
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