Telescopic Biliary Reconstruction in Patients Undergoing Liver Transplantation With 1-Year Follow-up.
BACKGROUND
Biliary complications are important during liver transplantation because of their effect on recipient and graft survival, incidence, and the long treatment period. These complications are associated with 50% morbidity and 30% mortality rates in recent studies. One of the most important reasons for biliary anastomosis complications is arterial ischemia. We present the results of our telescopic biliary anastomosis technique performed on the mucosa of the main biliary duct.


METHODS
Fifty-six cases of telescopic biliary reconstruction were performed in 203 patients during 2015. Fifty cases and 52 patients who underwent standard reconstruction were chosen and compared. All patients had been scanned retrospectively. Statistical analyses were conducted with χ2and Mann-Whitney U tests for the complications that occurred during the first 3 months. A P value <.05 was considered significant.


RESULTS
No clinical or demographic differences were detected between the groups. About 90% of both groups were living donor liver transplantation cases. Five (10%) anastomotic leaks occurred in telescopic reconstruction group (n = 50), and 13 (25%) occurred in the standard reconstruction group (n = 52; P < .05).


CONCLUSIONS
The arterial blood supply is better if the biliary anastomosis is made on the mucosal side of the main biliary duct. Early period anastomotic leaks may decrease significantly.
Department of Surgery, Inonu University Institute of Liver Transplantation, Malatya, Turkey. Electronic address: drserdarkarakas@gmail.com.
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Karakas
Department of Surgery, Inonu University Institute of Liver Transplantation, Malatya, Turkey.
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KB
Sarici
Department of Surgery, Inonu University Institute of Liver Transplantation, Malatya, Turkey.
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Ozdemir
Department of Surgery, Inonu University Institute of Liver Transplantation, Malatya, Turkey.
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Ersan
Department of Surgery, Inonu University Institute of Liver Transplantation, Malatya, Turkey.
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Ince
Department of Surgery, Inonu University Institute of Liver Transplantation, Malatya, Turkey.
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A
Baskiran
Department of Surgery, Inonu University Institute of Liver Transplantation, Malatya, Turkey.
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Kayaalp
Department of Radiology, Inonu University Institute of Liver Transplantation, Malatya, Turkey.
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Kutlu
Department of Surgery, Inonu University Institute of Liver Transplantation, Malatya, Turkey.
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Yilmaz
D000714:Anastomosis, Surgical / Q000379:methods; D057868:Anastomotic Leak / Q000209:etiology; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D016022:Case-Control Studies; D003135:Common Bile Duct / Q000098:blood supply / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000601:surgery; D006085:Graft Survival / Q000502:physiology; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000209:etiology; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery; D012189:Retrospective Studies