[Bile duct reconstruction in liver transplantation].
Complications of the biliary anatomosis are common after liver transplantation. Even with improved techniques the frequency of biliary complications is approximately ten percent. Main reason for this high morbidity rate is the unfavourable blood supply to the biliary tract. A variant of reconstructions has been described and recommended. The end-to-end-choledochocholedochostomy over a T tube turned out to be the preferred technique in most centers. In cases of different diameter of donor and recipient biliary tract, the side-to-side-choledochocholedochostomy provides a relayable alternative method. When the length of the bile duct doesn't allow direct anastomosis, the gallbladder-conduit may help to overcome this problem. The choledochojejunostomy with Roux-en-Y loop has become a frequently used biliary anastomosis, especially when the recipients bile duct is absent or otherwise destroyed. - Our own experience with fourteen liver transplantations shows biliary tract complications in three cases: a leakage and a stenosis of the anastomosis after choledochocholedochostomy were successfully transformed to a hepaticojejunostomy. In the third case, intrahepatic biliary stenosis were treated by percutaneous transhepatic dilatation.
Decurtins
M
M
Departement Chirurgie, Universitätsspital Zürich.
Lachat
M
M
Largiadèr
F
F
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods*; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D013536:Suture Techniques
Die Gallengangsrekonstruktion bei der Lebertransplantation.