2026-09-22T10:43:56Zhttps://repository.ajou.ac.kr/oai/request

oai:repository.ajou.ac.kr:201003/12932024-10-11T02:17:37Zcom_201003_14369com_201003_14368col_201003_14371

왕, 희정 김, 봉완 대학원 의학과 102308 김, 봉완 2011-01-26T04:58:51Z 2011-01-26T04:58:51Z 2010 2010 http://repository.ajou.ac.kr/handle/201003/1293 http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000010361 000000010361 Background. The biliary complications in duct-to-duct biliary reconstruction of right or left lobe living-donor liver transplantation (LDLT) have been reported various in incidence up to 40 %. And that could result in serious morbidity or mortality to the recipient’s. We evaluated the risk factors for biliary complication and feasible surgical procedure of duct-to-duct reconstruction in adult LDLT. Methods. From February 2005 to March 2008, 100 cases of adult LDLT with duct-to-duct biliary reconstruction were performed. 64 right lobe grafts, 33 left lobe grafts, and 3 right lateral grafts were used. There were four types of duct-to-duct procedure; all interrupted suture with 6-0 prolene (Group 1, n = 9), continuous posterior and interrupted anterior wall suture with 6-0 prolene (Group 2, n = 49), all continuous suture with 7-0 prolene (Group 3, n = 26), and all continuous 7-0 prolene suture with external stent (Group 4, n = 16). Biliary complications were defined as anastomosis stricture and leakage. Results. 34 patients experienced biliary complications during follow-up time (median 27 months). The incidence of stricture was 27% and that of leakage was 8%. There were no risk factors of biliary complication associated with peri-operative, intra-operative, and anatomical characteristics, except types of duct-to-duct procedure. Group 1 and 2 patients had higher incidence of biliary stricture than Group 3 and 4 (43.1% vs. 4.7%, P = 0.00). And Group 3 patients experienced higher incidence of bile leakage than other groups (23.1% vs. 2.7%, P = 0.004). Conclusion. The technical type of biliary reconstruction is the factor affecting biliary complication following duct-to-duct anastomosis in LDLT. Duct-to-duct biliary anastomosis with 7-0 monofilament suture and small external stent is a feasible procedure in LDLT to significantly reduce the incidence of biliary complication. Approved for entry into archive by Hyun Chul Cho (hccho@ajou.ac.kr) on 2011-01-26T04:58:51Z (GMT) No. of bitstreams: 1 000000010361.pdf: 1087815 bytes, checksum: bcae4e4576783d7e62a6ecdcae3dbd7b (MD5) Made available in DSpace on 2011-01-26T04:58:51Z (GMT). No. of bitstreams: 1 000000010361.pdf: 1087815 bytes, checksum: bcae4e4576783d7e62a6ecdcae3dbd7b (MD5) Submitted by Hyun Chul Cho (hccho@ajou.ac.kr) on 2011-01-26T04:58:51Z No. of bitstreams: 1 000000010361.pdf: 1087815 bytes, checksum: bcae4e4576783d7e62a6ecdcae3dbd7b (MD5) ABSTRACT i TABLE OF CONTENTS iii LIST OF TABLE iv LIST OF FIGURE v I. INTRODUCTION 1 II. PATIENTS AND METHODS 3 A.Preparation of Graft Bile duct 5 B.Recipient Operation 7 C.Diagnosis and Treatment of Biliary Complications 11 D.Statistical Analysis 12 III. RESULTS 13 IV. DISCUSSION 24 V. CONCLUSION 32 VI. REFERENCES 33 VII. 국문요약 36 Doctor en Duct-to-Duct Biliary Reconstructions and Complications in 100 Living Donor Liver Transplantation 담도-담도 문합술을 시행한 100례의 생체 부분 간이식 환자에서 담도합병증의 위험인자 분석 Thesis Theses Living donor liver transplantation Duct-to-duct anastomosis Biliary complication 2010 9999-12-31 9999-12-31