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Biliary reconstruction for infantile living donor liver transplantation: Roux‐en‐Y hepaticojejunostomy or duct‐to‐duct choledochocholedochostomy?
Author(s) -
Shirouzu Yasumasa,
Okajima Hideaki,
Ogata Satsuki,
Ohya Yuki,
Tsukamoto Yukika,
Yamamoto Hidekazu,
Takeichi Takayuki,
KwangJong Lee,
Asonuma Katsuhiro,
Inomata Yukihiro
Publication year - 2008
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21599
Subject(s) - medicine , liver transplantation , roux en y anastomosis , bile duct , living donor liver transplantation , surgery , incidence (geometry) , duct (anatomy) , gastroenterology , transplantation , gastric bypass , weight loss , physics , optics , obesity
Hepaticojejunostomy is a standard biliary reconstruction method for infantile living donor liver transplantation (LDLT), but choledochocholedochostomy for infants is not generally accepted yet. Ten pediatric recipients weighing no more than 10 kg underwent duct‐to‐duct choledochocholedochostomy (DD) for biliary reconstruction for LDLT. Patients were followed up for a median period of 26.8 months (range: 4.0–79.0 months). The incidence of posttransplant biliary complications for DD was compared with that for Roux‐en‐Y hepaticojejunostomy (RY). No DD patients and 1 RY patient (5%) developed biliary leakage ( P > 0.05), and biliary stricture occurred in 1 DD patient (10%) and none of the RY patients ( P > 0.05); none of the DD patients and 5 RY patients (25%) suffered from uncomplicated cholangitis after LDLT ( P > 0.05), and 1 DD patient (10%) and 2 RY patients (10%) died of causes unrelated to biliary complications. In conclusion, both hepaticojejunostomy and choledochocholedochostomy resulted in satisfactory outcome in terms of biliary complications, including leakage and stricture, for recipients weighing no more than 10 kg. Liver Transpl 14:1761–1765, 2008. © 2008 AASLD.