title: High incidence of biliary complications in rat liver transplantation: can we avoid it?
abstract: OBJECTIVE
  To investigate how to reduce the incidence of biliary complications in rat orthotopic liver transplantation.
  
  
  METHODS
  A total of 165 male Wistar rats were randomly divided into three groups: Group A, orthotropic liver transplantation with modified "two-cuff" technique; Group B, bile duct was cut and reconstructed without transplantation; and Group C, only laparotomy was performed. Based on the approaches used for biliary reconstruction, Group A was divided into two sub-groups:A1 (n = 30), duct-duct reconstruction, and A2 (n = 30), duct-duodenum reconstruction. To study the influence of artery reconstruction on bile duct complication, Group B was divided into four sub-groups: B1 (n = 10), duct-duct reconstruction with hepatic artery ligation, B2 (n = 10), duct-duct reconstruction without hepatic artery ligation, B3 (n = 10), duct-duodenum reconstruction with hepatic artery ligation, and B4 (n = 10), duct-duodenum reconstruction without hepatic artery ligation. The samples were harvested 14 d after operation or at the time when significant biliary complication was found.
  
  
  RESULTS
  In Group A, the anhepatic phase was 13.7 ± 1.06 min, and cold ischemia time was 50.5 ± 8.6 min. There was no significant difference between A1 and A2 in the operation duration. The time for biliary reconstruction was almost the same among all groups. The success rate for transplantation was 98.3% (59/60). Significant differences were found in the incidence of biliary complications in Groups A (41.7%), B (27.5%) and C (0%). A2 was more likely to have biliary complications than A1 (50% vs 33.3%). B3 had the highest incidence of biliary complications in Group B.
  
  
  CONCLUSIONS
  Biliary complications are almost inevitable using the classical "two cuff" techniques, and duct-duodenum reconstruction is not an ideal option in rat orthotopic liver transplantation.
authors.affiliation: Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 33 Yingfeng Road, Haizhu District, Guangzhou, Guangdong Province, China.
authors.forename: Guo-Lin
authors.initials: GL
authors.lastname: Li
authors.forename: Hao-Ming
authors.initials: HM
authors.lastname: Lin
authors.forename: Tian-Zhu
authors.initials: TZ
authors.lastname: Long
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Lv
authors.forename: Jian-Dong
authors.initials: JD
authors.lastname: Yu
authors.forename: Yong-Heng
authors.initials: YH
authors.lastname: Huang
authors.forename: Jun
authors.initials: J
authors.lastname: Min
authors.forename: Yun-Le
authors.initials: YL
authors.lastname: Wan
mesh_terms: D000818:Animals; D001652:Bile Ducts / Q000601:surgery; D001659:Biliary Tract / Q000473:pathology*; D006499:Hepatic Artery / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar