Results of Using the Cystic Duct for Reconstruction of One of the Multiple Bile Ducts in Right Lobe Living Donor Liver Transplantation |
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| Affiliation: | 1. Department of General Surgery, İstanbul Aydın University Training and Research Hospital, İstanbul, Turkey;2. Department of General Surgery, İstinye University Training and Research Hospital, İstanbul, Turkey;3. Department of Anesthesiology, İstinye University Training and Research Hospital, İstanbul, Turkey;1. Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea;2. Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, South Korea;3. Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea;1. Department of Surgery, Houston Methodist Hospital, Houston, Texas;2. Department of Pharmacy, University of Kansas Health System, Kansas City, Kansas;3. Department of Medicine, Houston Methodist Hospital, Houston, Texas;4. Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas;5. Department of Pharmacy, Houston Methodist Hospital, Houston, Texas;1. Pneumology Unit, University Hospital 12 de Octubre, Madrid, Spain;2. Digestive Unit, University Hospital 12 de Octubre, Madrid, Spain;3. Anesthesia Unit, University Hospital 12 de Octubre, Madrid, Spain;4. Rehabilitation Unit, University Hospital 12 de Octubre, Madrid, Spain;5. Thoracic Surgery Unit of University Hospital 12 de Octubre, Madrid, Spain;6. Center of Net Biomedical Investigation on Respiratory Diseases (CIBERES), Madrid, Spain;1. Department of Histology, Institute of Medical Sciences, University of Opole, Opole, Poland;2. Department of Pneumonology and Allergology, Medical University of Gdansk, Gdańsk, Poland;3. Department of Cardiac Surgery and Vascular Surgery, Medical University of Gdansk, Gdańsk, Poland;4. Medical University of Gdansk, Gdańsk, Poland;5. Department of Pathomorphology, Medical University of Gdansk, Gdańsk, Poland;6. Department of Radiology, Medical University of Gdansk, Gdańsk, Poland;1. Department of Vascular, General, and Transplantation Surgery, Division of Endovascular Surgery, Medical University of Wrocław, Wrocław, Poland;2. Department of Otolaryngology, Head and Neck Surgery, Medical University of Wrocław, Wrocław, Poland;3. Department of Vascular, General, and Transplantation Surgery, Medical University of Wrocław, Wrocław, Poland |
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| Abstract: | ![]()
BackgroundIn right-lobe liver grafts, variations in the biliary tree anatomy can result in multiple bile duct orifices. We present our experience of 10 patients in which biliary reconstruction was performed with the cystic duct for 1 of the anastomoses with 2 separated ducts. Also, we investigated whether the bile duct anastomosis technique, number of bile duct anastomoses, and use of biliary stents affect the rate of biliary complications.MethodsWe evaluated patients who underwent right-lobe living donor liver transplantation (LDLT) at İstinye University Hospital and İstanbul Aydın University Hospital between December 2017 and June 2020. The patients were divided into 4 groups: duct-to-duct (D-D), duct-to-sheath, double duct-to-duct, and duct-to-duct plus cystic duct-to-duct. Biliary complication rates were compared among these 4 groups, between single- and double-duct groups, and between stent (+) and stent (−) groups.ResultsNinety-three patients who underwent right-lobe LDLT (60 men, 33 women) with a mean age of 51 ± 13 years were included. Mean follow-up time was 18.5 ± 8.3 months. The overall biliary complication rate was 17.2% for all patients, 12.1% for the D-D (single-duct) group (33 patients), 16.1% for the duct-to-sheath group (31 patients), 26.3% for the double duct-to-duct group (19 patients), 20% for the duct-to-duct plus cystic duct-to-duct group (10 patients), 20% for the double-duct group (60 patients), 14.5% for the stent (+) group (69 patients), and 25% for the stent (−) group (24 patients). There were no significant differences among these groups in terms of biliary complication rates. Bile stricture occurred in only 1 cystic duct anastomosis (10%), and no bile leakage was observed.ConclusionsMultiple D-D biliary reconstruction using the cystic duct with external drainage tubes is feasible and safe for LDLT. |
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