A Modified Surgical Technique in Biliary Reconstruction in Living Donor Liver Transplantation and Its Impact on Postoperative Incidence of Biliary Leakage and Stricture

Abstract

Abstract Background Biliary complications continue to be a challenging territory in living donor liver transplantation that could lead eventually to graft loss and increased mortality. Despite the continuous evolution of biliary reconstruction techniques, there is no single full proof method that could possibly ensure the best biliary reconstruction. Aim of work In this study we compare the results of our combined modified technique of biliary reconstruction to the results of the conventional techniques in terms of improving biliary complications particularly biliary leaks and strictures. Methods This study was conducted on two equal groups of patients (recipients), 52 each, one of them received the conventional technique and the other received the modified technique. Results Our results have shown that the modified technique dropped the biliary complications from 36.5 to 9.6%, bile leaks dropped from 9.6% to 3.8%, and strictures dropped from 30.8% to 7.7%. Conclusion HPGS approach in the donor surgery together with en bloc hilar dissection and the eversion technique in the recipient surgery improve postoperative biliary complications.