DUCT-TO-DUCT BILIARY ANASTOMOSIS IN LIVING RELATED LIVER TRANSPLANTATION

Abstract

A159 Aims: Biliary duct to duct anastomosis in living-related liver transplantation for both adult and pediatric recipients is recently used in our center. We described our technique and early results of patients who underwent living related liver transplantation with duct to duct anastomosis. Methods: In last six month period (9/2003 to 3/2004) ten patients (8 living related and 2 cadaver) underwent orthotopic liver transplantation with duct to duct anastomosis with tube drainage in our center. Out of ten, 6 patients were in pediatric and 4 patients were in adult age group. During recipient hepatectomy, the common bile duct was dissected and cut above the left and right hepatic bifurcation into the liver. A modified parachute technique with absorb able monofilament suture (PDS) was used for anastomosis. In eight recipients, T-tube and in two recipients, straight feeding tube was used for external drainage which inserted from the recipient common bile duct. Results: All ten patients doing well with optimal liver functions in early post transplantation period. One pediatric patient who transplanted for fulminant hepatic failure secondary to HAV infection, died for ARDS in his 44th post transplantation day with well functioning graft. One patient had anastomotic leak which treated conservatively. Conclusions: According to our early results, giving 90% graft and patients survival rate without major complication, we consider duct to duct anastomosis technique in living related liver transplantation when there is no tension effected to the anastomosis. Otherwise Roux-en-Y hepatico-jejunostomy should be performed for decrease the risk of biliary complications.