Biliary reconstruction using the recipient's cystic duct in living donor liver transplantation

Abstract

Objective To study the teasibility ot using the recipient cystic duct for biliary reconstruction in living donor liver transplantation.Methods Between January 2008 and September 2011,5 patients underwent living donor liver transplantation with biliary reconstruction.The recipient 's cystic duct was anastomosed with one branch of the donor's bile duct,and other donor's bile ducts were anastomosed with hepatic duct or right hepatic duct.After transplantation,the recipients were followed up with liver function test.Radioscopy was preceded at 2nd week and 3rd month after transplantation.Results Two weeks after transplantation,cholangiography through the tubes showed no leakage or stricture at intrahepatic and extrahepatic bile ducts. Three patients recovered well without any hepatic dysfunction,and cholangiography showed well at 3rd month after operation.One patient had normal hepatic function after operation,and had not yet taken cholangiography.One patient recovered smoothly early,but after 3 months the cystic duct was tortuous with anastomotic stricture.The liver function was normal,and T tube was withdrawn.But 9 months later,hepatic dysfunction appeared,and the middle of the lumen was slightly narrowed in MRCP.Tacrolimus was replaced by Sirolimus,and the liver function returned to normal.Conclusion Biliary reconstruction using the cystic duct is feasible and safe for living donor liver transplantation. Key words: Liver Transplantation; Bile ducts; Cystic duct; Anastomosis, surgical