title: Biliary complications after right lobe living donor liver transplantation: a single-centre experience.
abstract: BACKGROUND
  Biliary complications that developed after right lobe liver transplantation from living donors were studied in a single centre.
  
  
  METHODS
  From 2004 to 2010, 200 consecutive living donor right lobe liver transplantations were performed. The database was evaluated retrospectively. Biliary complications were diagnosed according to clinical, biochemical and radiological tests. The number of biliary ducts in the transplanted graft, the surgical techniques used for anastomosis, biliary strictures and bile leakage rates were analysed.
  
  
  RESULTS
  Of a total of 200 grafts, 117 invloved a single bile duct, 77 had two bile ducts and in six grafts there were three bile ducts. In 166 transplants, the anastomosis was performed as a single duct to duct, in 21 transplants double duct to ducts, in one transplant, three duct to ducts and in 12 transplants as a Roux-en-Y reconstruction. In all, 40 bile leakages (20%) and 17 biliary strictures (8.5%) were observed in 49 patients resulting in a total of 57 biliary complications (28.5%). Seventeen patients were re-operated (12 as a result of bile leakages and five owing to biliary strictures).
  
  
  CONCLUSIONS
  Identification of more than one biliary orifice in the graft resulted in an increase in the complication rates. In grafts containing multiple orifices, performing multiple duct-to-duct (DD) or Roux-en-Y anastomoses led to a lower number of complications.
authors.affiliation: Florence Nightingale Hospital, Hepatobiliary and Organ Transplant Center, Istanbul, Turkey. onuryaprak@hotmail.com
authors.forename: Onur
authors.initials: O
authors.lastname: Yaprak
authors.forename: Murat
authors.initials: M
authors.lastname: Dayangac
authors.forename: Murat
authors.initials: M
authors.lastname: Akyildiz
authors.forename: Tolga
authors.initials: T
authors.lastname: Demirbas
authors.forename: Necdet
authors.initials: N
authors.lastname: Guler
authors.forename: Fisun
authors.initials: F
authors.lastname: Bulutcu
authors.forename: Nuray
authors.initials: N
authors.lastname: Bassullu
authors.forename: Elif
authors.initials: E
authors.lastname: Akun
authors.forename: Yildiray
authors.initials: Y
authors.lastname: Yuzer
authors.forename: Yaman
authors.initials: Y
authors.lastname: Tokat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D001652:Bile Ducts / Q000601:surgery*; D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult