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Roux‐en‐ Y h epatico‐jejunostomy for a left segmental graft: Do not twist the loop, stick it!
Author(s) -
Nadalin S.,
Monti L.,
Grimaldi C.,
Francesco F.,
Tozzi A. E.,
Ville de Goyet J.
Publication year - 2015
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12474
Subject(s) - medicine , biliary atresia , complication , surgery , jejunostomy , liver transplantation , anastomosis , gauche effect , loop (graph theory) , transplantation , parenteral nutrition , mathematics , combinatorics
Biliary complications remain a major challenge for long‐term success after LT , as it is, as a rule, the most common technical – early and late – complication that occurs, and because these complications contribute to a significant number of late graft losses and retransplantations. In the pediatric age group, both biliary atresia, as the patient's condition, and the use of a left liver graft, obtained by a liver division technique, make it necessary for the use of a R oux‐en‐ Y jejunal loop for the biliary reconstruction in the majority of cases. A slight modification of the technique is presented, consisting of a straight positioning along the cut surface (rather than the conventional position that results in a harpoon shape). A favorable outcome in terms of a technical complication and graft survival was observed. This way of doing this is an interesting variation and adds to the surgical armamentarium.