title: Outcome of duct-to-duct vs. Roux-en-Y hepaticojejunostomy biliary anastomoses in below 15-kg pediatric liver transplant recipients.
abstract: The best type of biliary anastomosis to use in lower weight pediatric liver transplant recipients is debatable. In this study, we share a single center's experience comparing the rate of anastomotic biliary complications based on the type of biliary anastomosis performed in this population of patients. A retrospective review of pediatric liver transplants for recipients weighing <15 kg from 11/2003 till 12/2011 was performed. Patients were grouped based on the type of biliary anastomosis into two groups: duct-to-duct (d-d) and Roux-en-Y hepaticojejunostomy (h-j) anastomoses. A total of 24 patients (12 males, 12 females) with a mean age of 26 ± 20 months and a mean weight of 9.27 ± 2.63 kg (range = 5.3-13.9 kg) were studied. All anastomotic complications occurred in patients who received left lateral segments. No statistical differences were found in the post-operative biliary (p = 0.86) or vascular (p = 0.99) complications between the two groups. Acknowledging the limited sample size, our data suggest that duct-to-duct anastomosis can be performed safely in pediatric liver transplantation recipients weighing below 15 kg.
authors.affiliation: Department of Hepatobiliary Surgery and Transplantation, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Shaheen
authors.forename: Moayad S
authors.initials: MS
authors.lastname: Alabdulkarim
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Hamshow
authors.forename: Khalid O
authors.initials: KO
authors.lastname: Abdullah
authors.forename: Wael A
authors.initials: WA
authors.lastname: O'Hali
mesh_terms: D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007583:Jejunum / Q000601:surgery*; D008099:Liver / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: biliary reconstruction; complications of liver transplantation; duct-to-duct anastomosis; pediatric liver transplantation