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  • Title: Intraoperative real-time cholangiography and C-tube drainage in donor hepatectomy reduce biliary tract complications.
    Author: Ochiai T, Ikoma H, Inoue K, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Kokuba Y, Sonoyama T, Otsuji E.
    Journal: J Gastrointest Surg; 2011 Dec; 15(12):2159-64. PubMed ID: 21956431.
    Abstract:
    BACKGROUND: In living-donor liver transplantation, biliary tract complications are a serious problem for recipients and donors. METHODS: We applied intraoperative real-time cholangiography using a C-arm and/or C-tube drainage to reduce biliary tract complications in donor hepatectomy. From 2003 to 2010, intraoperative real-time cholangiography and C-tube drainage was applied to 39 and 19 donor cases, respectively. Fifteen donor cases had both procedures. RESULTS: We confirmed the division line of the hepatic duct by visualizing a stricture on the monitor of the C-arm by pulling a thread and dissecting the proper site of the bile duct. The number of hepatic ducts of the graft to be anastomosed was 1 in 11 cases and 2 or 3 in 8 of the 19 cases without intraoperative real-time cholangiography, and it was 1 in 32 cases and 2 in 7 of the 39 cases with intraoperative real-time cholangiography. Bile leakage from the resection occurred in seven donors without, and in none of those with, C-tube drainage. CONCLUSION: In living-donor liver transplantation, intraoperative real-time cholangiography enables effective determination of the precise division line of the hepatic duct. Moreover, C-tube drainage is effective for reducing bile leakage from the resected surface of the liver of donors.
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