Biliary reconstruction for infantile living donor liver transplantation: Roux-en-Y hepaticojejunostomy or duct-to-duct choledochocholedochostomy?
Hepaticojejunostomy is a standard biliary reconstruction method for infantile living donor liver transplantation (LDLT), but choledochocholedochostomy for infants is not generally accepted yet. Ten pediatric recipients weighing no more than 10 kg underwent duct-to-duct choledochocholedochostomy (DD) for biliary reconstruction for LDLT. Patients were followed up for a median period of 26.8 months (range: 4.0-79.0 months). The incidence of posttransplant biliary complications for DD was compared with that for Roux-en-Y hepaticojejunostomy (RY). No DD patients and 1 RY patient (5%) developed biliary leakage (P > 0.05), and biliary stricture occurred in 1 DD patient (10%) and none of the RY patients (P > 0.05); none of the DD patients and 5 RY patients (25%) suffered from uncomplicated cholangitis after LDLT (P > 0.05), and 1 DD patient (10%) and 2 RY patients (10%) died of causes unrelated to biliary complications. In conclusion, both hepaticojejunostomy and choledochocholedochostomy resulted in satisfactory outcome in terms of biliary complications, including leakage and stricture, for recipients weighing no more than 10 kg.
Shirouzu
Yasumasa
Y
Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Science, Kumamoto University, Kumamoto, Japan. shirouzu@fc.kuh.kumamoto-u.ac.jp
Okajima
Hideaki
H
Ogata
Satsuki
S
Ohya
Yuki
Y
Tsukamoto
Yukika
Y
Yamamoto
Hidekazu
H
Takeichi
Takayuki
T
Kwang-Jong
Lee
L
Asonuma
Katsuhiro
K
Inomata
Yukihiro
Y
D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D001835:Body Weight; D002768:Choledochostomy / Q000379:methods; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007582:Jejunostomy / Q000379:methods; D007583:Jejunum / Q000601:surgery*; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male