Biliary complications after right lobe living donor liver transplantation: a single-centre experience
Article first published online: 25 OCT 2011
© 2011 International Hepato-Pancreato-Biliary Association
Volume 14, Issue 1, pages 49–53, January 2012
How to Cite
Yaprak, O., Dayangac, M., Akyildiz, M., Demirbas, T., Guler, N., Bulutcu, F., Bassullu, N., Akun, E., Yuzer, Y. and Tokat, Y. (2012), Biliary complications after right lobe living donor liver transplantation: a single-centre experience. HPB, 14: 49–53. doi: 10.1111/j.1477-2574.2011.00401.x
- Issue published online: 8 DEC 2011
- Article first published online: 25 OCT 2011
- Received 17 August 2011; accepted 14 September 2011
- liver transplantation;
- biliary complications;
- living donor;
- bile leakage
Background: Biliary complications that developed after right lobe liver transplantation from living donors were studied in a single centre.
Methods: From 2004 to 2010, 200 consecutive living donor right lobe liver transplantations were performed. The database was evaluated retrospectively. Biliary complications were diagnosed according to clinical, biochemical and radiological tests. The number of biliary ducts in the transplanted graft, the surgical techniques used for anastomosis, biliary strictures and bile leakage rates were analysed.
Results: Of a total of 200 grafts, 117 invloved a single bile duct, 77 had two bile ducts and in six grafts there were three bile ducts. In 166 transplants, the anastomosis was performed as a single duct to duct, in 21 transplants double duct to ducts, in one transplant, three duct to ducts and in 12 transplants as a Roux-en-Y reconstruction. In all, 40 bile leakages (20%) and 17 biliary strictures (8.5%) were observed in 49 patients resulting in a total of 57 biliary complications (28.5%). Seventeen patients were re-operated (12 as a result of bile leakages and five owing to biliary strictures).
Conclusion: Identification of more than one biliary orifice in the graft resulted in an increase in the complication rates. In grafts containing multiple orifices, performing multiple duct-to-duct (DD) or Roux-en-Y anastomoses led to a lower number of complications.