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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 27 time in Scopus
Authors
Yi, Nam-Joon; Suh, Kyung-Suk; Cho, Jai Young; Kwon, Choon Hyuck; Lee, Kuhn Uk
Issue Date
2005-10-14
Publisher
Blackwell Publishing
Citation
Transpl Int. 2005 Nov;18(11):1240-7
Keywords
AdultAnastomosis, Roux-en-YBile Ducts/*surgeryBiliary Tract Surgical ProceduresCholestasis/*epidemiologyFemaleHumansIncidenceJejunum/*surgeryLiver Transplantation/*methods/statistics & numerical data*Living DonorsMaleMiddle AgedPostoperative Complications/*epidemiologyRetrospective StudiesStentsTreatment Outcome
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
DOI
https://doi.org/10.1111/j.1432-2277.2005.00209.x
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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