Bile duct reconstruction without a stent in liver transplantation: early results of a single center.
Biliary complications may present significant problems in orthotopic liver transplantation (OLT). Herein we have presented our outcomes of a biliary reconstruction technique without stenting in deceased- and living-donor OLT. Between September 2001 and May 2007, we performed 174 OLTs in 172 recipients. Before December 2006, we used various drainage techniques for biliary reconstruction. We retrospectively reviewed the biliary reconstructions performed without a drainage catheter in 33 OLTs (19 males, 14 females; median age, 25.2 +/- 20.7 years; range, 0.5-60 years) since December 2006. Thirteen of the 33 recipients were children: 7 were younger than 1 year at the time of OLT. Biliary reconstruction was performed with a duct-to-duct anastomosis in 25 recipients and with a Roux-en-Y hepaticojejunostomy in 8. Nine of the 33 grafts had 2 bile ducts, 2 had 3 bile ducts, and the remaining 22 had 1 bile duct. Biliary leak from the anastomotic site was seen in 1 recipient. The biliary stenoses observed in 2 recipients after OLT were treated with interventional radiologic techniques. Mean follow-up was 4.1 +/- 1.6 months (range, 20 days to 7 months). Biliary reconstruction without using a stent is safe for deceased- and living-donor OLT in all ages.
Haberal
M
M
Department of General Surgery and Transplantation, Faculty of Medicine, Baskent University, Ankara, Turkey. rektorluk@baskent-ank.edu.tr
Sevmis
S
S
Karakayali
H
H
Moray
G
G
Torgay
A
A
Arslan
G
G
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D015607:Stents