Feasibility of duct-to-duct biliary reconstruction in left-lobe adult-living-donor liver transplantation

Yuji Soejima, Mitsuo Shimada, Taketoshi Suehiro, Keiji Kishikawa, Ryosuke Minagawa, Shoji Hiroshige, Mizuki Ninomiya, Satoko Shiotani, Noboru Harada, Keizo Sugimachi

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Abstract

A Roux-en-Y choledochojejunostomy (CDJ) has been the sole method of choice for the reconstruction of the bile duct in living-donor liver transplantation (LDLT) using left-lobe grafts. In this study, we evaluated the feasibility of duct-to-duct (DD) biliary reconstruction in adult-to-adult LDLT using left-lobe grafts. Between October 1996 and October 2001, 46 adult-to-adult LD-LTs using the left lobe were performed at our institution. The DD biliary reconstruction (hepaticocholedochostomy) over a T-tube was performed for seven of the last nine recipients (DD group, n=7), whereas the conventional Roux-en-Y CDJ was used for the remaining cases (CDJ group, n=39). The technical problems and the incidence of biliary complications were compared between the groups. Bile leakage developed in only 1 of 7 (14%) in the DD group (leakage from a T-tube exit site), whereas it occurred in 8 of 39 (20%) in the CDJ group. Up to now, no patients from the DD group developed anastomotic stricture, whereas twelve (30.7%) patients from the CDJ group did. Other complications included bleeding from the Roux-en-Y jejunojejunostomy (n=1) and anastomotic occlusion caused by an internal stent (n=1), and both complications were associated with CDJ. In conclusion, DD anastomosis is a simple and viable option for biliary reconstruction in left-lobe LDLTs. A long-term follow-up, especially regarding the incidence of biliary stricture, is thus warranted in such patients.

Original languageEnglish
Pages (from-to)557-559
Number of pages3
JournalTransplantation
Volume75
Issue number4
DOIs
Publication statusPublished - Feb 27 2003

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All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Soejima, Y., Shimada, M., Suehiro, T., Kishikawa, K., Minagawa, R., Hiroshige, S., ... Sugimachi, K. (2003). Feasibility of duct-to-duct biliary reconstruction in left-lobe adult-living-donor liver transplantation. Transplantation, 75(4), 557-559. https://doi.org/10.1097/01.TP.0000048220.90971.5A