title: Delayed construction of the bilio-digestive anastomosis in right living donor liver transplantation.
abstract: We describe a two-step procedure in the transplantation of a right lobe liver graft obtained from a living donor, in which the biliary anastomosis is delayed until the day after the actual implantation of the graft. The purpose of the two-step procedure is to minimize the factors that might contribute to biliary complications in living donor liver transplantation (LDLT). Three patients who received a graft with two hepatic ducts underwent Roux-en-Y hepatico-jejunostomies during a separate procedure the day after the implantation of the graft. Length of intubation, recovery of enteral alimentation, and hospital stay were similar to the patients who underwent one-step transplant. No biliary or infectious complications occurred. Delaying the hepatico-jejunostomy when two ducts are present and a bilio-digestive anastomosis is planned has no negative impact on the postoperative course of the patients but can ameliorate the conditions under which the anastomoses must be performed.
authors.affiliation: Department of Surgery, Division of Transplantation, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Testa
authors.forename: Diego
authors.initials: D
authors.lastname: Bogetti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Panaro
authors.forename: Howard
authors.initials: H
authors.lastname: Sankary
authors.forename: Enrico
authors.initials: E
authors.lastname: Benedetti
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D006500:Hepatic Duct, Common / Q000601:surgery*; D006801:Humans; D007582:Jejunostomy; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D001219:Aspartate Aminotransferases