Biliary reconstruction and complications of living donor liver transplantation
10.3760/cma.j.issn.1007-8118.2010.01.007
- VernacularTitle:活体肝移植的胆道重建技术及并发症分析
- Author:
Yamin ZHANG
;
Zhijun ZHU
;
Tao YANG
;
Jiancun HOU
;
Jinzhen CAI
;
Lin WEI
;
Hairuing ZHANG
;
Zhongyang SHEN
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Biliary tract reconstruction;
Biliary complication
- From:
Chinese Journal of Hepatobiliary Surgery
2010;16(1):15-18
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe the feasibility of biliary reconstruction methods and to explore the preventing and curing methods for biliary complications. Methods A total of 77 cases of living donor liver transplantation were included in our study for retrospective analysis. The operation types included right lobe contain middle hepatic vein (n=29), right lobe without middle hepatic vein (n=45), left lobe (n=1) and left lateral lobe transplantation (n=1). The biliary reconstruction was performed by duct-to-duct and Roux-en-Y epaticojejunostomy. Results Fifty-four grafts had 1 bile duct and 23 had multiple ones. The duct-to-duct biliary reconstruction was performed for 75 adult cases and T-tube drainage was used in 63 patients. Meanwhile, the conventional Roux-en-Y epaticojejunostomy was utilized for 2 pediatric patients. Total biliary complication incidence was 36.4% (28/77) and the complications included bile leakage (10.4%, 8/77) and biliary stricture (26.0%, 20/77).The rate of biliary complication was remarkably different between single hepatic duct group and multiple group (P<0.05). All the 8 patients suffering from bile leakage were cured by percutaneous bile drainage guided by ultrasound. By percutaneous balloon cholangioplasty and placing stent through the T-tube tract or endoscopic retrograde balloon cholangioplasty, the liver function of biliary stricture cases got better and most cases were cured. Conclusion Protecting the blood supply of bile duct at the cutting surface and harvesting one bile duct stump as much as possible can reduce biliary complication effectively. Radiate intervention treatment such as percutaneous balloon cholangioplasty and endoscope treatment etc. are effective for treatment of biliary complications.
