title: Roux-en-Y hepatico-jejunostomy for a left segmental graft: Do not twist the loop, stick it!
abstract: Biliary complications remain a major challenge for long-term success after LT, as it is, as a rule, the most common technical - early and late - complication that occurs, and because these complications contribute to a significant number of late graft losses and retransplantations. In the pediatric age group, both biliary atresia, as the patient's condition, and the use of a left liver graft, obtained by a liver division technique, make it necessary for the use of a Roux-en-Y jejunal loop for the biliary reconstruction in the majority of cases. A slight modification of the technique is presented, consisting of a straight positioning along the cut surface (rather than the conventional position that results in a harpoon shape). A favorable outcome in terms of a technical complication and graft survival was observed. This way of doing this is an interesting variation and adds to the surgical armamentarium.
authors: Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany.
authors: S
authors: S
authors: Nadalin
authors: L
authors: L
authors: Monti
authors: C
authors: C
authors: Grimaldi
authors: F
authors: F
authors: di Francesco
authors: A E
authors: AE
authors: Tozzi
authors: J
authors: J
authors: de Ville de Goyet
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007582:Jejunostomy / Q000379:methods*; D008099:Liver / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies
keywords: biliary reconstruction; children; complications of liver transplantation; pediatric liver transplantation