Diagnostic and therapeutic management algorithm for biliary complications in living liver donors.
biliary complications
hepaticojejunostomy
living donor hepatectomy
living donor liver transplantation
percutaneous transhepatic biliary tract drainage
Journal
Transplant international : official journal of the European Society for Organ Transplantation
ISSN: 1432-2277
Titre abrégé: Transpl Int
Pays: Switzerland
ID NLM: 8908516
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
01
09
2021
received:
19
02
2021
accepted:
05
09
2021
pubmed:
13
9
2021
medline:
15
12
2021
entrez:
12
9
2021
Statut:
ppublish
Résumé
This study aimed to demonstrate the efficacy of our diagnostic and therapeutic management algorithm and catheter-assisted (percutaneous transhepatic biliary tract drainage [PTBD] or transanastomotic feeding tube) hepaticojejunostomy (HJ) procedures in living liver donors (LLDs) with biliary complications. Living donor hepatectomy (LDH) was performed between September 2005 and April 2021 in 2 489 LLDs. Biliary complications developed in 220 LLDs (8.8%), 136 of which were male, and the median age was 29 (interquartile range [IQR]: 12) years. Endoscopic sphincterotomy ± stenting was performed in 132 LLDs, which was unsuccessful in 9 LLDs and required HJ. Overall, 142 LLDs underwent interventional radiologic procedures. Fifteen LLDs with biliary complications underwent HJ (PTBD catheter = 6 and transanastomotic feeding tube = 9) at a median of 44 days (IQR: 82). Following HJ, 14 LLDs did not have any complications throughout the median follow-up period of 1619 days (IQR: 1454). However, percutaneous dilation for HJ anastomotic stricture was performed in one patient. Biliary complications are very common following LDH; therefore, surgeons in the field should have a low threshold to perform HJ for biliary complications that persist after other treatments. Our catheter-assisted HJ techniques demonstrated a high success rate and aided HJ in a hostile abdomen during revisional surgery.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2226-2237Informations de copyright
© 2021 Steunstichting ESOT. Published by John Wiley & Sons Ltd.
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