title: A thoracoabdominal approach in revision of the hepatic hilum after left lobe living donor liver transplantation.
abstract: We present an approach to safely expose the hepatic hilum for revision procedures after left lobe living donor liver transplantation. A 14-year-old adolescent girl who had undergone left lobe living donor liver transplantation experienced repeated episodes of cholangitis. Because treatment with interventional techniques failed, surgical revision was indicated. The right thoracoabdominal approach was selected to minimize dissection. Intraoperative findings showed adhesive kinking of the Roux-Y limb just distal to the bilioenteric anastomosis, and a side-to-side jejunojejunostomy was performed. The thoracoabdominal approach leads to easy and excellent reoperative exposure of the hilar site of a left lobe liver graft.
authors.affiliation: Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Honda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takeichi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ohya
authors.forename: Kenji
authors.initials: K
authors.lastname: Okumura
authors.forename: Kwang-Jong
authors.initials: KJ
authors.lastname: Lee
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Asonuma
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Inomata
mesh_terms: D000293:Adolescent; D001656:Biliary Atresia / Q000601:surgery*; D002761:Cholangitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007582:Jejunostomy; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D013908:Thoracotomy