title: Biliary complications in 106 consecutive duct-to-duct biliary reconstruction in right-lobe living donor liver transplantation performed in 1 year in a single center: a new surgical technique.
abstract: OBJECTIVE
  Biliary complications remain a major source of morbidity after living donor liver transplantation (LDLT). Of 109 consecutive right lobe (RL)-LDLTs performed in 1 year in our institution, we present the biliary complications among 106 patients who underwent a new duct-to-duct anastomosis technique known as University of Inonu.
  
  
  METHODS
  Of 153 liver transplantations performed in 1 year from January to December of 2008, 128 were LDLTs including 109 RL-LDLTs. The others were left or left lateral grafts. All RL-LDLT patients were adults, all of whom except three included a duct-to-duct anastomosis.
  
  
  RESULTS
  All, but three, biliary reconstructions were completed with a surgical technique, so called UI, in which 6-0 prolene sutures were used. Nine bile leaks were seen in 106 recipients (8.49%) performed in a duct-to-duct fashion in a time period of 1 to 4 weeks. Seventeen patients (16.03%) posed bile duct stricture (BDS). Five patients had both. Although endoscopic stent placement and percutaneous balloon dilatation, 4 patients continued to suffer from BDS on whom a permanent access hepatico-jejunostomy (PAHJ) procedures were performed.
  
  
  CONCLUSIONS
  We recommend a duct-to-duct biliary reconstruction because of its de facto advantages over other types of anastomosis provided the native duct is not diseased. After almost 2 years, the bile tract complication rate was 22.64%.
authors.affiliation: General Surgery Department, Yeni Yuzyil University School of Medicine, Uskudar, Istanbul, Turkey. vkirimlioglu@inonu.edu.tr
authors.forename: V
authors.initials: V
authors.lastname: Kirimlioglu
authors.forename: F
authors.initials: F
authors.lastname: Tatli
authors.forename: V
authors.initials: V
authors.lastname: Ince
authors.forename: C
authors.initials: C
authors.lastname: Aydin
authors.forename: V
authors.initials: V
authors.lastname: Ersan
authors.forename: C
authors.initials: C
authors.lastname: Ara
authors.forename: M
authors.initials: M
authors.lastname: Aladag
authors.forename: R
authors.initials: R
authors.lastname: Kutlu
authors.forename: H
authors.initials: H
authors.lastname: Kirimlioglu
authors.forename: S
authors.initials: S
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001660:Biliary Tract Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged