Roux-en-Y Choledochojejunostomy is the method of choice for biliary reconstruction in liver transplantation for primary sclerosing cholangitis.
BACKGROUND
Opinion is divided regarding the optimal method of biliary reconstruction after liver transplantation for primary sclerosing cholangitis (PSC).


METHODS
We investigated biliary complications and graft and patient survival in all patients who underwent liver transplantation for PSC in the United Kingdom between 1994 and 2003.


RESULTS
Anastomotic leak rates were similar, but a significantly higher stricture rate was observed in patients who had a duct-to-duct reconstruction compared with those who underwent a Roux-en-Y anastomosis. Graft and patient survival were also markedly worse in patients with a duct-to-duct anastomosis.


CONCLUSIONS
Roux-en-Y choledochojejunostomy is the method of choice for biliary reconstruction in liver transplantation for PSC.
Welsh
Fenella K S
FK
Department of Transplant Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
Wigmore
Stephen J
SJ
D000713:Anastomosis, Roux-en-Y; D001652:Bile Ducts / Q000601:surgery*; D015209:Cholangitis, Sclerosing / Q000601:surgery*; D002768:Choledochostomy; D006085:Graft Survival; D006801:Humans; D007582:Jejunostomy; D016031:Liver Transplantation; D012189:Retrospective Studies; D016019:Survival Analysis