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Hepatic artery reconstruction and biliary stricture formation after living donor adult liver transplantation using the left lobe
Author(s) -
Suehiro Taketoshi,
Ninomiya Mizuki,
Shiotani Satoko,
Hiroshige Syoji,
Harada Noboru,
Ryosuke Minagawa,
Soejima Yuji,
Shimada Mitsuo,
Sugimachi Keizo
Publication year - 2002
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 - 10.1053/jlts.2002.32986
Subject(s) - medicine , anastomosis , liver transplantation , perioperative , artery , transplantation , living donor liver transplantation , surgery , gastroenterology , biliary tract surgical procedures , biliary tract
Biliary complications, including bile leak, biliary stricture, and cholangitis, are seen in 15% to 29% of all cases after living related liver transplantation. We investigate risk factors and discuss the management of biliary complications after living related liver transplantation in adults using left‐lobe grafts. We studied 37 adult patients who underwent living related liver transplantation using left‐lobe grafts. Perioperative variables were evaluated as risk factors for biliary strictures. The overall incidence of biliary complications was 43.2% (16 of 37 patients). Anastomotic strictures occurred in 8 patients, whereas bile leaks and cholangitis occurred in 9 and 8 patients, respectively. Anastomotic stricture was strongly related to a partial artery reconstruction ( P < .02) and cholangitis ( P < .01). Anastomotic biliary stricture was not associated with bile leak, acute cellular rejection, or infection. Our results suggest that an important risk factor for biliary anastomotic biliary strictures is a partial artery reconstruction. To minimize the risk for biliary anastomotic strictures, we will reconstruct both the middle and left hepatic artery.