Management of biliary complications following living donor liver transplantation--a single center experience.
OBJECTIVE
Biliary complications (BC) after living donor liver transplantation (LDLT) are reported in up to 32%. We retrospectively reviewed the biliary reconstruction after 95 LDLT.


METHODS
Eighty-one right hemiliver grafts and 14 left lateral section grafts were transplanted. Bile duct anastomoses were performed as duct-to-duct (DD) or bilioenteric anastomosis (RYHJ); multiple bile ducts were anastomosed using a ductoplasty or multiple direct bile duct anastomoses.


RESULTS
After right hemiliver LDLT, a total of 45.5% of BC was observed, with an incidence of 27.7% in case of DD anastomosis and 18.8% in case of RYHJ. After DD anastomosis, strictures were successfully treated endoscopically in 50%; insufficiencies mainly required reoperations.


CONCLUSIONS
BC still account for a high percentage of morbidity and mortality after LDLT. DD anastomoses are performed more frequently and are feasible in cases with simple biliary anatomy; RYHJ is the gold standard for the reconstruction of multiple bile ducts.
Kohler
Sven
S
Department of Transplant Surgery, Charité-Universitaetsmedizin Berlin, Campus Virchow Clinic, Berlin, Germany.
Pascher
Andreas
A
Mittler
Jens
J
Neumann
Ulf
U
Neuhaus
Peter
P
Pratschke
Johann
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002768:Choledochostomy; D015331:Cohort Studies; D006801:Humans; D007223:Infant; D007582:Jejunostomy; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008875:Middle Aged; D011171:Portoenterostomy, Hepatic; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult