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Duct-to-duct biliary reconstructions and complications in 100 living donor liver transplantations.

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dc.contributor.authorKim, BW-
dc.contributor.authorBae, BK-
dc.contributor.authorLee, JM-
dc.contributor.authorWon, JH-
dc.contributor.authorPark, YK-
dc.contributor.authorXu, WG-
dc.contributor.authorWang, HJ-
dc.contributor.authorKim, MW-
dc.date.accessioned2010-12-07T05:30:07Z-
dc.date.available2010-12-07T05:30:07Z-
dc.date.issued2009-
dc.identifier.issn0041-1345-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/458-
dc.description.abstractOBJECTIVE: We evaluated the risk factors for biliary complications and surgical procedures for duct-to-duct reconstructions in adult living donor liver transplantation (LDLT).



PATIENTS AND METHODS: From February 2005 to March 2008, we performed 100 cases of adult LDLT with duct-to-duct biliary reconstruction, using 64 right lobe grafts, 33 left lobe grafts, and 3 right lateral grafts. We employed 4 types of duct-to-duct procedures: all interrupted 6-0 Prolene suture (group 1, n = 9); continuous posterior and interrupted anterior wall 6-0 Prolene suture (group 2, n = 49); all continuous 7-0 Prolene suture (group 3, n = 26); and all continuous 7-0 Prolene suture with external stent (group 4, n = 16). Biliary complications were defined as an anastomosis stricture or a leakage.



RESULTS: Thirty-four patients experienced biliary complications during the follow-up period (median, 27 months). The incidence of stricture was 27% and that of leakage, 8%. There were no perioperative, intraoperative, or anatomic risk factors for biliary complications, except the type of duct-to-duct procedure. Group 1 and 2 patients showed higher incidences of biliary strictures than groups 3 and 4 (43.1% vs 4.7%; P = .00). Group 3 patients experienced a higher incidence of bile leakage than the other groups (23.1% vs 2.7%; P = .004).



CONCLUSIONS: The type of biliary reconstruction is a factor affecting biliary complications following duct-to-duct anastomosis in LDLT. Duct-to-duct biliary anastomosis with 7-0 monofilament suture and a small external stent is a feasible procedure in LDLT that significantly reduces the incidence of biliary complications.
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dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAnastomosis, Surgical-
dc.subject.MESHBile Ducts-
dc.subject.MESHFemale-
dc.subject.MESHGallbladder-
dc.subject.MESHHumans-
dc.subject.MESHLiver Transplantation-
dc.subject.MESHLiving Donors-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPatient Selection-
dc.subject.MESHPostoperative Complications-
dc.subject.MESHReconstructive Surgical Procedures-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Factors-
dc.titleDuct-to-duct biliary reconstructions and complications in 100 living donor liver transplantations.-
dc.typeArticle-
dc.identifier.pmid19545721-
dc.identifier.urlhttp://linkinghub.elsevier.com/retrieve/pii/S0041-1345(09)00448-5-
dc.contributor.affiliatedAuthor김, 봉완-
dc.contributor.affiliatedAuthor배, 병구-
dc.contributor.affiliatedAuthor원, 제환-
dc.contributor.affiliatedAuthor왕, 희정-
dc.contributor.affiliatedAuthor김, 명욱-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.transproceed.2009.02.097-
dc.citation.titleTransplantation proceedings-
dc.citation.volume41-
dc.citation.number5-
dc.citation.date2009-
dc.citation.startPage1749-
dc.citation.endPage1755-
dc.identifier.bibliographicCitationTransplantation proceedings, 41(5). : 1749-1755, 2009-
dc.identifier.eissn1873-2623-
dc.relation.journalidJ000411345-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
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