Open AccessIn adult‐to‐adult living donor liver transplantation hepaticojejunostomy shows a better long‐term outcome than duct‐to‐duct anastomosis *
Author(s) -
Yi NamJoon,
Suh KyungSuk,
Cho Jai Young,
Kwon Choon Hyuck,
Lee Kuhn Uk
Publication year - 2005
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2005.00209.x
Subject(s) - medicine , anastomosis , liver transplantation , bile duct , surgery , stent , living donor liver transplantation , gastroenterology , complication , incidence (geometry) , biliary tract , roux en y anastomosis , group b , transplantation , gastric bypass , physics , optics , weight loss , obesity
Summary Roux‐en‐Y hepaticojejunostomy (RYHJ) has been the standard biliary reconstruction in adult‐to‐adult living donor liver transplantation (ALDLT). Recently, duct‐to‐duct anastomosis (DD) has been introduced. This study compared the outcomes of RYHJ and DD. For 4 years, 74 recipients underwent ALDLT and were followed up for at least 2 years. The patients were divided into three groups, RYHJ group ( n = 18), DD with a stent (DD + S) group ( n = 35), and DD without a stent (DD − S) group ( n = 21). Overall, biliary complications were developed in 32.4% patients. The biliary complication rate was 11.1%, 48.5% and 33.3% in RYHJ, DD + S and DD − S groups, respectively ( P = 0.047). Bile leaks occurred in 28.5% of DD + S group. The incidence of biliary stricture was 5.3%, 20.2% and 28.6% in RYHJ, DD + S and DD − S group, respectively. Most complications (83.3%) were resolved nonsurgically. RYHJ has a better long‐term outcome than DD in ALDLT. Subgroup analysis of DD group showed that DD − S group had no bile leaks, but still had a higher incidence of bile duct strictures. However, because this study was a retrospective review there are limitations in analyzing the data and confirming the conclusion. A randomized‐prospective study will be needed to confirm these findings.