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  • Title: Duct-to-duct biliary anastomosis with a "corner-saving suture" technique in living-related liver transplantation.
    Author: Dalgic A, Moray G, Emiroglu R, Sozen H, Karakayali H, Boyacioglu S, Bilgin N, Haberal M.
    Journal: Transplant Proc; 2005 Sep; 37(7):3137-40. PubMed ID: 16213329.
    Abstract:
    OBJECTIVES: Biliary complications after living-related liver transplantation (LRLT) remain a major source of morbidity for recipients. We describe our technique and early results with 32 recipients who underwent LRLT with duct-to-duct anastomoses during the last 2 years. METHODS: Between January 2003 and December 2004, 50 patients underwent liver transplantation in our center with overall patient and graft survival rate of 86.4% and 86.4%. Of 50 patients, 41 (82.0%; 17 adult and 24 pediatric) underwent LRLT, 32 (78.0%) of whom had duct-to-duct biliary anastomoses with a "corner-saving suture" technique. RESULTS: Of 32 patients in whom duct-to-duct biliary anastomoses were performed, 4 (12.5%) had an anastomotic leak with 2 eventually developing bile duct strictures within 3 months. One patient required reoperation for a bile leak. All other anastomotic leaks and strictures were treated with percutaneous drainage and balloon dilatation with excellent outcomes. There was no long-term morbidity and no graft loss owing to biliary complications. Seven patients died during follow-up (0.5 to 25 months); 43 are doing well with optimal liver function in the early posttransplantation period. CONCLUSION: According to our early results, we recommend duct-to-duct anastomosis in LRLT when calibration of the ducts show suitable results and when there is no tension on the anastomosis site. Otherwise, Roux-en-Y hepaticojejunostomy should be performed to decrease risk of biliary complications.
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