Technical Aspects of Biliary Reconstruction Correlated with Biliary Complications in 46 Consecutive Right Lobe Liver Transplantations from Living Donors
V. Braşoveanu, C. Anghel, N. Bacalbaşa, M.I. Ionescu, E. Matei, I. Barbu, M. Grasu, D. Tomescu, I. PopescuOriginal article, no. 1, 2014
Introduction: Biliary complications contribute to a highmorbidity rate in patients with right lobe liver transplant froma living donor. We retrospectively evaluated biliary reconstructionsand complications in a number of recipients with livertransplant from a living donor, in a single center.Patients and Methods: A number of 46 patients (23 males and 23females aged 9-63) received a right lobe liver graft between2009 and 2013, with the following types of biliary reconstruction:duct-to-duct choledochocholedochal anastomosis (n=24)or Roux-en-Y hepaticojejunoanastomosis, with or without anexternal transanastomotic biliary stent.Results: The rate of biliary complications (leakage 15.21%,anastomotic stenosis 4.34%, overall 17.39%) was notstatistically significantly influenced by the demographics of the studied lot, by the etiology of the liver disease or by thecharacteristics of the biliary reconstruction; the only risk factorwhich showed a statistically significant influence in terms ofbiliary complications was MELD.Conclusion: The type and technique of the biliary reconstructionin LDLT should be adapted depending on the anatomy ofthe biliary tree of both the donor and recipient, as well as theclinical and laboratory findings of the recipient.
