Feasibility of duct-to-duct biliary reconstruction in pediatric living related liver transplantation: report of three cases.
Feasibility of duct-to-duct biliary reconstruction in adult living related liver transplantation (LRLTx) has been recently reported; however, little has been known of its surgical outcome in children. To assess the feasibility and safety of duct-to-duct biliary reconstruction in children, the surgical outcomes of duct-to-duct biliary reconstruction were retrospectively analyzed. The subjects were three children who underwent LRLTx in our hospital each utilizing allografts with a right lobe, a left robe and a lateral segment, respectively. The cause of end-stage liver disease in each of them was fulminant Wilson's disease, fulminant hepatic failure and unresectable hepatoblastoma. Duct-to-duct anastomosis was performed in younger patients and adolescents with interrupted and continuous sutures, respectively. The diameter of bile duct in allografts was from 4 to 6 mm and 12 or 13 stitches were required for anastomosis. Post-operative choledochography from the external tube showed neither stenosis nor leakage and the tube was evacuated within 3 months after LRLTx. No biliary complications were observed with the median follow-up of 28 months. In conclusion, our results show that duct-to-duct biliary reconstructions in pediatric LRLTx seemed to be feasible and safe. Further studies are required to elucidate its real impact on pediatric LRLTx.
Kimura
Takuya
T
Division of Pediatric Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. kimutaku@pedsurg.med.osaka-u.ac.jp
Hasegawa
Toshimichi
T
Ihara
Yoshiyuki
Y
Nara
Keigo
K
Sasaki
Takashi
T
Dono
Keizo
K
Mushiake
Sotarou
S
Fukuzawa
Masahiro
M
D000293:Adolescent; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D018197:Hepatoblastoma / Q000601:surgery; D006527:Hepatolenticular Degeneration / Q000601:surgery; D006801:Humans; D017114:Liver Failure, Acute / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies; D013536:Suture Techniques; D014184:Transplantation, Homologous