Biliary strictures in living donor liver transplantation: Incidence, management and technical evolution

Yuji Soejima, Akinobu Taketomi, Tomoharu Yoshizumi, Hideaki Uchiyama, Noboru Harada, Hideki Ijichi, Yusuke Yonemura, Tetsuo Ikeda, Mitsuo Shimada, Yoshihiko Maehara

研究成果: Contribution to journalArticle査読

91 被引用数 (Scopus)

抄録

Biliary complications, biliary strictures (BS) in particular, continue to be a significant cause of morbidity after LDLT despite technical refinement. In this study, we assessed the incidence of BS and their management in living donor liver transplantation (LDLT) with special reference to the type of biliary reconstruction. A total of 182 LDLTs performed at our institution for either adult (n = 157) or pediatric (n = 25) patients were included in the study. The duct-to-duct (DD) biliary reconstruction was performed for 106 cases, while the conventional Roux-en-Y hepaticojejunostomy (HJ) was utilized for the remaining 76 cases. Overall, BS developed in 46/182 (25.3%) of the cases (DD, 26.4%; HJ, 25.0%). The 1- and 3-year cumulative incidences of BS were 22.9% and 31.9%, respectively, in the DD group, and 15.2% and 29.1%, respectively, in the HJ group (P = not significant). The left-lobe LDLT was more prone to develop BS. Continuous anastomosis tended to be associated with the high incidence of BS in the DD group. The incidence of anastomotic leak was significantly lower in the DD group. Intervention via either precutaneous or endoscopic approach was successful in the majority of cases, although recurrence could occur in some patients. In conclusion, BS was not associated with the type of reconstruction in LDLT. The primary radiological or endoscopic interventions were satisfactory treatments of choice. Technical refinement is an important factor to reduce the incidence of BS.

本文言語英語
ページ(範囲)979-986
ページ数8
ジャーナルLiver Transplantation
12
6
DOI
出版ステータス出版済み - 6 1 2006

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation

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