title: Single-center experience and long-term outcomes of duct-to-duct biliary reconstruction in infantile living donor liver transplantation.
abstract: The indications for duct-to-duct (DD) biliary reconstruction in living donor liver transplantation (LDLT) for small children are still controversial. In this study, the feasibility of DD biliary reconstruction versus Roux-en-Y (RY) biliary reconstruction was investigated in terms of long-term outcomes. Fifty-six children who consecutively underwent LDLT with a weight less than or equal to 10.0 kg were enrolled. Biliary reconstruction was performed in a DD fashion for 20 patients and in an RY fashion for 36 patients. During a minimum follow-up of 2 years, the incidence of biliary strictures was 5.0% in the DD group and 11.1% in the RY group. Cholangitis during the posttransplant period was observed in the RY group only. There were no deaths related to biliary problems. This study shows that DD reconstruction in LDLT for small children (weighing 10.0 kg or less) is a feasible option for biliary reconstruction.
authors.affiliation: Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Shintaro
authors.initials: S
authors.lastname: Hayashida
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Asonuma
authors.forename: Masaki
authors.initials: M
authors.lastname: Honda
authors.forename: Hiroko
authors.initials: H
authors.lastname: Suda
authors.forename: Takahiro
authors.initials: T
authors.lastname: Murokawa
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ohya
authors.forename: Kwang-Jong
authors.initials: KJ
authors.lastname: Lee
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takeichi
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Inomata
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods*; D001652:Bile Ducts / Q000601:surgery; D001835:Body Weight; D002675:Child, Preschool; D002758:Cholangiography / Q000379:methods; D002761:Cholangitis / Q000209:etiology; D002779:Cholestasis / Q000209:etiology; D058625:End Stage Liver Disease / Q000601:surgery / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D016896:Treatment Outcome