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Article: Safety of duct-to-duct biliary reconstruction in right-lobe live-donor liver transplantation without biliary drainage

TitleSafety of duct-to-duct biliary reconstruction in right-lobe live-donor liver transplantation without biliary drainage
Authors
Issue Date2004
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com
Citation
Transplantation, 2004, v. 77 n. 5, p. 726-732 How to Cite?
AbstractBackground. Duct-to-duct biliary reconstruction is frequently used in right-lobe live-donor liver transplantation (RLDLT), and routine biliary drainage has been recommended. The aim of the present study was to evaluate the safety and operative outcomes of duct-to-duct biliary reconstruction after RLDLT without biliary drainage. Methods. The study comprised 41 RLDLT recipients who had duct-to-duct biliary reconstruction. During donor and recipient operations, precautions were taken to preserve blood supply to the bile duct. Biliary anastomosis was performed with fine Prolene sutures without stents or drainage tubes. The operative outcomes were prospectively evaluated. Results. The median postoperative intensive care unit and hospital stay were 3 days (range, 1-47 days) and 19 days (range, 8-114 days), respectively. There was no hospital mortality. At a median follow-up of 13.3 months (range, 4.0-26. 8 months), the graft and patient survival rates were 95% and 98%, respectively. Three (7%) patients had biliary leakage. These three patients and the other seven patients developed biliary stricture. The overall biliary complication rate was 24%. On multivariate analysis, preoperative Model for End-Stage Liver Disease (MELD) score of greater than or equal to 35 was the risk factor associated with biliary complication (P=0.032; risk ratio, 4.58). Conclusions. Duct-to-duct anastomosis without biliary drainage is safe in RLDLT. Patients with a high preoperative MELD score were associated with an increased incidence of biliary complications. Further studies are required to investigate the hemodynamic changes and modulation of blood flow of liver grafts in patients with chronic liver disease, which may significantly affect the incidence of biliary complications.
Persistent Identifierhttp://hdl.handle.net/10722/84413
ISSN
2014 Impact Factor: 3.828
2013 SCImago Journal Rankings: 1.609
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorChan, SCen_HK
dc.contributor.authorFan, STen_HK
dc.date.accessioned2010-09-06T08:52:41Z-
dc.date.available2010-09-06T08:52:41Z-
dc.date.issued2004en_HK
dc.identifier.citationTransplantation, 2004, v. 77 n. 5, p. 726-732en_HK
dc.identifier.issn0041-1337en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84413-
dc.description.abstractBackground. Duct-to-duct biliary reconstruction is frequently used in right-lobe live-donor liver transplantation (RLDLT), and routine biliary drainage has been recommended. The aim of the present study was to evaluate the safety and operative outcomes of duct-to-duct biliary reconstruction after RLDLT without biliary drainage. Methods. The study comprised 41 RLDLT recipients who had duct-to-duct biliary reconstruction. During donor and recipient operations, precautions were taken to preserve blood supply to the bile duct. Biliary anastomosis was performed with fine Prolene sutures without stents or drainage tubes. The operative outcomes were prospectively evaluated. Results. The median postoperative intensive care unit and hospital stay were 3 days (range, 1-47 days) and 19 days (range, 8-114 days), respectively. There was no hospital mortality. At a median follow-up of 13.3 months (range, 4.0-26. 8 months), the graft and patient survival rates were 95% and 98%, respectively. Three (7%) patients had biliary leakage. These three patients and the other seven patients developed biliary stricture. The overall biliary complication rate was 24%. On multivariate analysis, preoperative Model for End-Stage Liver Disease (MELD) score of greater than or equal to 35 was the risk factor associated with biliary complication (P=0.032; risk ratio, 4.58). Conclusions. Duct-to-duct anastomosis without biliary drainage is safe in RLDLT. Patients with a high preoperative MELD score were associated with an increased incidence of biliary complications. Further studies are required to investigate the hemodynamic changes and modulation of blood flow of liver grafts in patients with chronic liver disease, which may significantly affect the incidence of biliary complications.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.comen_HK
dc.relation.ispartofTransplantationen_HK
dc.rightsThis is a non-final version of an article published in final form in Transplantation, 2004, v. 77 n. 5, p. 726-732en_HK
dc.subject.meshBile Ducts - metabolism - surgery-
dc.subject.meshCholestasis - epidemiology - metabolism - surgery-
dc.subject.meshLiver Transplantation - methods - statistics and numerical data-
dc.subject.meshLiving Donors-
dc.subject.meshPostoperative Complications - epidemiology-
dc.titleSafety of duct-to-duct biliary reconstruction in right-lobe live-donor liver transplantation without biliary drainageen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0041-1337&volume=77&issue=5&spage=726&epage=732&date=2004&atitle=Safety+of+duct-to-duct+biliary+reconstruction+in+right-lobe+live-donor+liver+transplantation+without+biliary+drainageen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/01.TP.0000116604.89083.2Fen_HK
dc.identifier.pmid15021836en_HK
dc.identifier.scopuseid_2-s2.0-1642364926en_HK
dc.identifier.hkuros90496en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-1642364926&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume77en_HK
dc.identifier.issue5en_HK
dc.identifier.spage726en_HK
dc.identifier.epage732en_HK
dc.identifier.isiWOS:000220323700015-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridChan, SC=7404255575en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK

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