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.
Artigo
em Coreano
| 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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Suturas
/
Doadores de Tecidos
/
Bile
/
Ductos Biliares
/
Colangiografia
/
Calcanhar
/
Stents
/
Inquéritos e Questionários
/
Transplante de Fígado
/
Doadores Vivos
Tipo de estudo:
Guia de Prática Clínica
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Coreano
Revista:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Ano de publicação:
2010
Tipo de documento:
Artigo
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