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Article: Outcomes of side-to-side conversion hepaticojejunostomy for biliary anastomotic stricture after right-liver living donor liver transplantation

TitleOutcomes of side-to-side conversion hepaticojejunostomy for biliary anastomotic stricture after right-liver living donor liver transplantation
Authors
KeywordsBiliary anastomotic stricture
Living donor liver transplantation
Right-liver
Hepaticojejunostomy
Endoscopic treatment
Duct-to-duct anastomosis
Issue Date2013
Citation
Hepatobiliary and Pancreatic Diseases International, 2013, v. 12, n. 1, p. 42-46 How to Cite?
AbstractBACKGROUND: Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture, a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis, after failed endoscopic treatment. The aim of this study is to compare the outcomes of side-to-side hepaticojejunostomy with those of end-to-side hepaticojejunostomy. METHODS: Prospectively collected data of 402 adult patients who had undergone right-liver living donor liver transplantation with duct-to-duct anastomosis were reviewed. Diagnosis of biliary anastomotic stricture was made based on clinical, biochemical, histological and radiological results. Endoscopic treatment was the first-line treatment of biliary anastomotic stricture. RESULTS: Interventional radiological or endoscopic treatment failed to correct the biliary anastomotic stricture in 13 patients, so they underwent conversion hepaticojejunostomy. Ten of them received end-to-side hepaticojejunostomy and three received side-to-side hepaticojejunostomy. In the end-to-side group, two patients sustained hepatic artery injury requiring repeated microvascular anastomosis, two developed re-stenosis requiring further percutaneous transhepatic biliary drainage and balloon dilatation, and two required revision hepaticojejunostomy. In the side-to-side group, one patient developed re-stenosis requiring further endoscopic retrograde cholangiography and balloon dilatation. No re-operation was needed in this group. Otherwise, outcomes in the two groups were similar in terms of liver function and graft survival. CONCLUSIONS: Despite the similar outcomes, side-to-side hepaticojejunostomy may be a better option for bile duct reconstruction after failed interventional radiological or endoscopic treatment because it can decrease the chance of hepatic artery injury and allows future endoscopic treatment if re-stricture develops. However, more large-scale studies are warranted to validate the results. © 2013, Hepatobiliary Pancreat Dis Int.
Persistent Identifierhttp://hdl.handle.net/10722/221335
ISSN
2015 Impact Factor: 1.724
2015 SCImago Journal Rankings: 0.717

 

DC FieldValueLanguage
dc.contributor.authorChok, KSH-
dc.contributor.authorChan, SC-
dc.contributor.authorCheung, TT-
dc.contributor.authorChan, ACY-
dc.contributor.authorSharr, WW-
dc.contributor.authorFan, ST-
dc.contributor.authorLo, CM-
dc.date.accessioned2015-11-18T06:09:02Z-
dc.date.available2015-11-18T06:09:02Z-
dc.date.issued2013-
dc.identifier.citationHepatobiliary and Pancreatic Diseases International, 2013, v. 12, n. 1, p. 42-46-
dc.identifier.issn1499-3872-
dc.identifier.urihttp://hdl.handle.net/10722/221335-
dc.description.abstractBACKGROUND: Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture, a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis, after failed endoscopic treatment. The aim of this study is to compare the outcomes of side-to-side hepaticojejunostomy with those of end-to-side hepaticojejunostomy. METHODS: Prospectively collected data of 402 adult patients who had undergone right-liver living donor liver transplantation with duct-to-duct anastomosis were reviewed. Diagnosis of biliary anastomotic stricture was made based on clinical, biochemical, histological and radiological results. Endoscopic treatment was the first-line treatment of biliary anastomotic stricture. RESULTS: Interventional radiological or endoscopic treatment failed to correct the biliary anastomotic stricture in 13 patients, so they underwent conversion hepaticojejunostomy. Ten of them received end-to-side hepaticojejunostomy and three received side-to-side hepaticojejunostomy. In the end-to-side group, two patients sustained hepatic artery injury requiring repeated microvascular anastomosis, two developed re-stenosis requiring further percutaneous transhepatic biliary drainage and balloon dilatation, and two required revision hepaticojejunostomy. In the side-to-side group, one patient developed re-stenosis requiring further endoscopic retrograde cholangiography and balloon dilatation. No re-operation was needed in this group. Otherwise, outcomes in the two groups were similar in terms of liver function and graft survival. CONCLUSIONS: Despite the similar outcomes, side-to-side hepaticojejunostomy may be a better option for bile duct reconstruction after failed interventional radiological or endoscopic treatment because it can decrease the chance of hepatic artery injury and allows future endoscopic treatment if re-stricture develops. However, more large-scale studies are warranted to validate the results. © 2013, Hepatobiliary Pancreat Dis Int.-
dc.languageeng-
dc.relation.ispartofHepatobiliary and Pancreatic Diseases International-
dc.subjectBiliary anastomotic stricture-
dc.subjectLiving donor liver transplantation-
dc.subjectRight-liver-
dc.subjectHepaticojejunostomy-
dc.subjectEndoscopic treatment-
dc.subjectDuct-to-duct anastomosis-
dc.titleOutcomes of side-to-side conversion hepaticojejunostomy for biliary anastomotic stricture after right-liver living donor liver transplantation-
dc.typeArticle-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1016/S1499-3872(13)60004-1-
dc.identifier.pmid23392797-
dc.identifier.scopuseid_2-s2.0-84874239775-
dc.identifier.hkuros213637-
dc.identifier.volume12-
dc.identifier.issue1-
dc.identifier.spage42-
dc.identifier.epage46-

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