Hepatic artery reconstruction and biliary stricture formation after living donor adult liver transplantation using the left lobe.
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.
Suehiro
Taketoshi
T
Department of Surgery and Medical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. takeman@surg2.med.kyushu-u.ac.jp
Ninomiya
Mizuki
M
Shiotani
Satoko
S
Hiroshige
Syoji
S
Harada
Noboru
N
Ryosuke
Minagawa
M
Soejima
Yuji
Y
Shimada
Mitsuo
M
Sugimachi
Keizo
K
D000328:Adult; D002779:Cholestasis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects*