[Introduction of microvascular surgery to biliary reconstruction in living donor liver transplantation].
OBJECTIVE
To explore the feasibility of introduction of microvascular surgery into biliary reconstruction in living donor liver transplantation (LDLT) so as to reduce the incidence of postoperative biliary complications.


METHODS
The experience in the microvascular surgery performed on 32 patients undergoing LDLT, 8 children and 24 adults, including duct-to-duct anastomosis in 21 case, hepato-jejunostomy under surgical loupe in 13 cases, and hepato-jejunostomy under operative microscopy in 9 cases, totally 43 cases of biliary reconstruction manipulations.


RESULTS
Post-operative biliary complications occurred in 2 patients. One male patient who underwent hepato-jejunostomy under surgical loupe suffered from leakage from a bilioenteric anastomotic stoma 3 days after operation and laparotomy was performed to repair the leakage and carry out drainage. Mild stricture of the anastomotic stoma occurred in the other patient 3 months after operation and conservative treatment was given. Both patients recovered.


CONCLUSIONS
Introduction of microvascular surgery to biliary reconstruction in LDLT, especially the use of operative microscopy for hepato-jejunostomy on very small hepatic ducts, <or= 2 mm in diameter, achieves good results, with significant reduction of post-operative complications.
Yan
Lü-nan
LN
Transplantation Division, Department of Surgery, West China Hospital, Sichuan University Medical School, Chengdu 610041, China.
Li
Bo
B
Zeng
Yong
Y
Wen
Tian-fu
TF
Zhao
Ji-chun
JC
Wang
Wen-tao
WT
Yang
Jia-yin
JY
Xu
Ming-qing
MQ
Ma
Yu-kui
YK
Chen
Zhe-yu
ZY
Liu
Jiang-wen
JW
Wu
Hong
H
D000293:Adolescent; D000328:Adult; D001652:Bile Ducts / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002768:Choledochostomy; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008866:Microsurgery; D008875:Middle Aged