title: Duct-to-duct biliary reconstruction in pediatric living donor liver transplantation.
abstract: The results of duct-to-duct biliary reconstruction in six pediatric patients who received a living donor liver transplant aged from 2 months to 11 yr old are reported. The graft was either entire or a part of the left lateral segments. The orifice of the bile duct of the graft was anastomosed to the recipients' hepatic duct in an end-to-end fashion by interrupted suture using 6-0 absorbable material. A transanastomotic external stent tube (4 Fr) was passed through the stump of the recipients' cystic duct. Mean time for reconstruction was 24 min. All the recipients survived the operation and reinitiated oral intake on postoperative day 3. There were no early biliary complications. One 5-yr-old boy suffered from an anastomotic stenosis 9 months after transplantation. He underwent re-anastomosis by Roux-en Y (R-Y) procedure and recovered uneventfully. Duct-to-duct anastomosis in pediatric living donor liver transplantation has benefits while the complication rate is comparable to R-Y reconstruction.
authors.affiliation: Department of Transplantation/Pediatric Surgery, Postgraduate School of Medicine Science, Kumamoto University, Honjo Kumamoto, Japan. hokajima@fc.kuh.kumamoto-u.ac.jp
authors.forename: Hideaki
authors.initials: H
authors.lastname: Okajima
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Inomata
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Asonuma
authors.forename: Mikako
authors.initials: M
authors.lastname: Ueno
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takeichi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kodera
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshimoto
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ohya
mesh_terms: D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome