Characteristics of biliary reconstruction, using a T-tube, as compared to those with other methods, in left-lobe adult living-donor liver transplantation.
OBJECTIVE
Postoperative biliary tract complications remain one of the most serious problems facing patients who undergo living-donor liver transplantation. The aim of this study was to analyze the clinical implications of three different methods of biliary reconstruction in left-lobe adult living-donor liver transplantation.


METHODS
We retrospectively compared three groups of patients: those who had Roux-en-Y hepaticojejunostomy (HJ; n = 11) biliary reconstruction, those who had duct-to-duct hepaticohepaticostomy (HH) with external stent (n = 11), and those who had HH with a T-tube (n = 6). Median follow-up for each group was 31, 30, and 10 months, respectively.


RESULTS
Bile leaks were observed in 45.5% of the patients in both the HJ group and the HH with external stent group. Biliary anastomotic strictures occurred in 9% of the Roux-en-Y HJ patients and in 27.2% of those who had HH with external stent. No biliary complications were observed in the HH with a T-tube group (P = 0.049).


CONCLUSIONS
Biliary reconstruction using HH with a T-tube may decrease the incidence of biliary complications. Despite the relatively short follow-up period, these encouraging preliminary results may warrant further studies of this biliary reconstruction technique in left-lobe adult living-donor liver transplantation.
Kobayashi
Takashi
T
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan.
Sato
Yoshinobu
Y
Yamamoto
Satoshi
S
Takeishi
Toshiyuki
T
Oya
Hiroshi
H
Hirano
Ken-ichiro
K
Nakatsuka
Hideki
H
Watanabe
Takaoki
T
Hatakeyama
Katsuyoshi
K
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000473:pathology / Q000601:surgery*; D003251:Constriction, Pathologic; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged