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Endoscopic treatment of biliary complications after right‐lobe living‐donor liver transplantation with duct‐to‐duct biliary anastomosis
Author(s) -
Yazumi Shujiro,
Yoshimoto Takanobu,
Hisatsune Hiroshi,
Hasegawa Kazunori,
Kida Masaya,
Tada Shinsuke,
Uenoyama Yoshito,
Yamauchi Junichi,
Shio Seiji,
Kasahara Mureo,
Ogawa Kohei,
Egawa Hiroto,
Tanaka Koichi,
Chiba Tsutomu
Publication year - 2006
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-005-1084-y
Subject(s) - medicine , anastomosis , bile duct , liver transplantation , surgery , transplantation
Background/Purpose The aims of this study were to characterize the features of the biliary complications that occur after right‐lobe living‐donor liver transplantation (RL‐LDLT) with duct‐to‐duct biliary anastomosis, and to evaluate the efficacy of treating biliary complications endoscopically. Methods The records of 273 consecutive patients who underwent RL‐LDLT with duct‐to‐duct biliary anastomosis from July 1999 through July 2005 at Kyoto University Hospital were reviewed to determine the overall incidence of postoperative biliary complications and the outcome of endoscopic repair of those complications. Results Biliary complications occurred in 93 (34.1%) of the patients. These complications were: 80 biliary strictures (75 anastomotic and 5 nonanastomotic) and 16 biliary leakages (5 patients with biliary leakage also had a biliary stricture); most (72%) of the anastomotic strictures were complex (i.e., fork‐shaped or trident‐shaped). The strictures and leakages were repaired by the endoscopic placement of multiple inside stents above the sphincter of Oddi, and by nasobiliary drainage, respectively. The procedure was successful in repairing 51 (68.0%) of the anastomotic strictures and 8 (50.0%) of the biliary leakages. Conclusions Endoscopic stenting of the bile ducts is efficacious in treating biliary complications related to RL‐LDLT with duct‐to‐duct biliary anastomosis and the stenting should be attempted before surgical revision of strictures and leakages.