Surgical Technique of Biliary Reconstruction in Adult-to-Adult Living Donor Liver Transplantation: Survey of 9 Major Centers in Korea
Korean Journal of Hepato-Biliary-Pancreatic Surgery
;
: 219-226, 2010.
Article
Dans Coréen
| WPRIM
| ID: wpr-8322
ABSTRACT
PURPOSE:
Despite refinements in the surgical techniques for adult-to-adult living donor liver transplantation (ALDLT), biliary complications still remain the Achilles' heel of ALDLT. Moreover, there is no consensus for the ideal technique of biliary reconstruction to reduce the rate of complications to an acceptable range. We strove to collate the available data of the current surgical techniques for biliary reconstruction in ALDLT in Korea.METHODS:
A questionnaire concerning the surgical techniques for biliary reconstruction was sent to 9 surgeons who performed biliary anastomosis in the major LDLT centers of Korea (the response rate was 100%).RESULTS:
MR cholangiography (n=7) and/or intra-operative cholangiography (n=5) were routinely performed to evaluate the donor biliary anatomy. All the participants (n=9) preferred duct-to-duct anastomosis to hepatico-jejunostomy. Anastomosis was usually made on the whole layer (n=7 epithelium, n=2) of recipient's common hepatic duct under loupe magnification (n=8); only one center reconstructed the anastomosis on the 2nd order hepatic duct under view of a surgical microscope. There were various techniques for biliary reconstruction as follows suture material (absorbable n=5, non-absorbable n=4), suture method (continuous n=4, interrupted n=3, mixed n=3) and the use of a biliary stent (routine n=3, sometimes n=5, rare n=1). Ductoplasty was performed on the back table (n=7) for the cases with a very close distance (<5 mm) between the bile ducts' openings, but each duct was separately anastomosed to the recipients' bile duct (n=8) or a roux-en-Y limb (n=1) was done in cases with a distance more than 10 mm.CONCLUSION:
In 9 LDLT centers of Koreas, duct-to-duct was preferred; however, there was no unique consensus, among the major centers, for the biliary reconstruction techniques that might reduce complications.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Matériaux de suture
/
Donneurs de tissus
/
Bile
/
Conduits biliaires
/
Cholangiographie
/
Talon
/
Endoprothèses
/
Enquêtes et questionnaires
/
Transplantation hépatique
/
Donneur vivant
Type d'étude:
Guide de pratique
Limites du sujet:
Humains
Pays comme sujet:
Asie
langue:
Coréen
Texte intégral:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Année:
2010
Type:
Article
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