Outcome of routine use of microsurgical biliary reconstruction in pediatric living donor liver transplantation

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• 作者：Chao-Long Chen (1)
  Allan M. Concejero (1)
  Tsan-Shiun Lin (1)
  Yu-Hung Lin (1)
  Yuan-Cheng Chiang (1)
  Chih-Chi Wang (1)
  Shih-Ho Wang (1)
  Chih-Che Lin (1)
  Yueh-Wei Liu (1)
  Chee-Chien Yong (1)
  
• 关键词：Biliary reconstruction ; Microsurgical technique ; Biliary complications ; Pediatric living donor liver transplant ; Pediatrics
• 刊名：Journal of Hepato-Biliary-Pancreatic Sciences
• 出版年：2013
• 出版时间：June 2013
• 年：2013
• 卷：20
• 期：5
• 页码：492-497
• 全文大小：255KB
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• 作者单位：Chao-Long Chen (1)
  Allan M. Concejero (1)
  Tsan-Shiun Lin (1)
  Yu-Hung Lin (1)
  Yuan-Cheng Chiang (1)
  Chih-Chi Wang (1)
  Shih-Ho Wang (1)
  Chih-Che Lin (1)
  Yueh-Wei Liu (1)
  Chee-Chien Yong (1)
  
  1. Liver Transplantation Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, Taiwan
  

文摘

Objective Microsurgical techniques, initially used for hepatic artery reconstruction, have been extended to biliary reconstruction to decrease biliary complications. The routine use of microsurgical biliary reconstruction in pediatric living donor liver transplantation (LDLT) has not been elucidated. Methods Sixty-seven pediatric patients underwent primary LDLT. All biliary reconstructions were performed by a single microsurgeon using microsurgical techniques. A biliary stent was not used. The minimum follow-up was 12?months. Thirty-four patients had a minimum follow-up of 36?months. The outcomes of those who underwent microsurgical biliary reconstruction were compared with the outcomes of a cohort of 67 patients who underwent conventional biliary reconstruction. Results The demographical and clinical profiles of the two groups were not significantly different. There were 5 anastomotic complications in the conventional and 2 anastomotic complications in the microsurgical reconstruction groups. All complications developed within 90?days after transplant. There were no late biliary complications. Further analysis showed that conventional reconstruction increased the risk of biliary complications by 2.4 times (relative risk: 2.42; attributable risk: 4.5). Conclusion The routine use of microsurgical biliary reconstruction in pediatric LDLT is a technical innovation that led to decreased anastomotic biliary complications.