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Article: Safety of duct-to-duct biliary reconstruction in right-lobe live-donor liver transplantation without biliary drainage
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TitleSafety of duct-to-duct biliary reconstruction in right-lobe live-donor liver transplantation without biliary drainage
 
AuthorsLiu, CL1
Lo, CM1
Chan, SC1
Fan, ST1
 
Issue Date2004
 
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com
 
CitationTransplantation, 2004, v. 77 n. 5, p. 726-732 [How to Cite?]
DOI: http://dx.doi.org/10.1097/01.TP.0000116604.89083.2F
 
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.
 
ISSN0041-1337
2012 Impact Factor: 3.781
2012 SCImago Journal Rankings: 1.521
 
DOIhttp://dx.doi.org/10.1097/01.TP.0000116604.89083.2F
 
ISI Accession Number IDWOS:000220323700015
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLiu, CL
 
dc.contributor.authorLo, CM
 
dc.contributor.authorChan, SC
 
dc.contributor.authorFan, ST
 
dc.date.accessioned2010-09-06T08:52:41Z
 
dc.date.available2010-09-06T08:52:41Z
 
dc.date.issued2004
 
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.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationTransplantation, 2004, v. 77 n. 5, p. 726-732 [How to Cite?]
DOI: http://dx.doi.org/10.1097/01.TP.0000116604.89083.2F
 
dc.identifier.doihttp://dx.doi.org/10.1097/01.TP.0000116604.89083.2F
 
dc.identifier.epage732
 
dc.identifier.hkuros90496
 
dc.identifier.isiWOS:000220323700015
 
dc.identifier.issn0041-1337
2012 Impact Factor: 3.781
2012 SCImago Journal Rankings: 1.521
 
dc.identifier.issue5
 
dc.identifier.openurl
 
dc.identifier.pmid15021836
 
dc.identifier.scopuseid_2-s2.0-1642364926
 
dc.identifier.spage726
 
dc.identifier.urihttp://hdl.handle.net/10722/84413
 
dc.identifier.volume77
 
dc.languageeng
 
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com
 
dc.publisher.placeUnited States
 
dc.relation.ispartofTransplantation
 
dc.relation.referencesReferences in Scopus
 
dc.rightsThis is a non-final version of an article published in final form in Transplantation, 2004, v. 77 n. 5, p. 726-732
 
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 drainage
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong