Biliary reconstructions and complications encountered in 50 consecutive right-lobe living donor liver transplantations

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dc.contributor.authorIcoz, G
dc.contributor.authorKilic, M
dc.contributor.authorZeytunlu, M
dc.contributor.authorCelebi, A
dc.contributor.authorErsoz, G
dc.contributor.authorKilli, R
dc.contributor.authorMemis, A
dc.contributor.authorKarasu, Z
dc.contributor.authorYuzer, Y
dc.contributor.authorTokat, Y
dc.date.accessioned2019-10-27T19:00:25Z
dc.date.available2019-10-27T19:00:25Z
dc.date.issued2003
dc.departmentEge Üniversitesien_US
dc.description.abstractBiliary complications appear to be the leading cause of postoperative complications after living donor liver transplantation (LDLT). The aim of this study is to analyze the complications, treatment modalities, and outcomes of biliary anastomoses in a series of 50 consecutive right-lobe LDLTs. Median patient age was 45 years, and median right-lobe graft volume was 740 g. Graft-recipient weight ratio was 0.69 to 1.80. Median follow-up time was 15 months (range, 2 to 38 months). Eleven of 50 patients died, resulting in an overall allograft and patient survival rate of 78%. In biliary reconstruction, a duct-to-duct (D-D) anastomosis or a standard Roux-en-Y (R-Y) anastomosis was performed. Twenty-nine grafts (58%) had a single duct for anastomosis. Seventeen grafts (34%) had two bile duct orifices, and four grafts (8%) had three bile duct orifices. A D-D anastomosis was performed in 36 cases (72%), whereas R-Y reconstruction was preferred in 14 cases (28%). The overall incidence of biliary anastomotic complications was 30% in this series. Five patients developed biliary leaks, presumably from the cut surface, and all of them healed spontaneously. Two bilomas were drained percutaneously. Anastomotic strictures occurred in 8 patients (16%) and were significantly greater than in the R-Y group (P =.03). Although strictures seemed to develop more frequently in allografts with multiple bile ducts, this did not reach statistical significance (P =.05). All strictures were managed by nonsurgical measures initially. Restenosis occurred in 2 patients, both of whom had an R-Y anastomotic stricture. These anastomoses were revised surgically, giving a reoperation rate of 4% for biliary problems. No graft or patient was lost because of biliary problems. Our data suggest that D-D anastomosis is a safe and feasible method of biliary reconstruction in LDLT by preserving physiological bilioenteric continuity and allowing easy access through endoscopic techniques.en_US
dc.identifier.doi10.1053/jlts.2003.50129en_US
dc.identifier.endpage580en_US
dc.identifier.issn1527-6465
dc.identifier.issn1527-6473
dc.identifier.issue6en_US
dc.identifier.pmid12783398en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage575en_US
dc.identifier.urihttps://doi.org/10.1053/jlts.2003.50129
dc.identifier.urihttps://hdl.handle.net/11454/37777
dc.identifier.volume9en_US
dc.identifier.wosWOS:000183252300007en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofLiver Transplantationen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleBiliary reconstructions and complications encountered in 50 consecutive right-lobe living donor liver transplantationsen_US
dc.typeArticleen_US

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