MODIFICATIONS TO TYPICAL SURGERY TECHNIQUES FROM A LIVING DONOR TAKEN DURING ORTHOTOPIC LIVER TRANSPLANTATION

Abstract

To improve the typical methodology of liver transplantation, the authors developed changes: first of all, it was established that during orthotopic transplantation of a liver taken from a living donor, biliary complications are mainly formed in those patients in which knotted sutures were used in the creation of bilio-biliary anastomosis, therefore, in recent operations, we used continuous sutures, which reduced the number of complications by 9%. In the second case - when it was not possible to mobilize the bile ducts of sufficient size, we used the following changes in the methodology: we picked the longest section at the base of the small intestine and prepared a 10-15 cm loop of the intestine for resection. After the mentioned above, we made a window in the transverse mesocolon so that we had a loop of the resected and end-stitched intestine in the resulting defect, while maintaining the nutrition of the section of the resected intestine. In the later stage of the operation, at one end of the intestine, we sewed the donor's and the recipient's bile ducts with continuous sutures from both sides, and at the other end we sewed the recipient's common bile duct. We closed the "window" in a transverse mesocolon so that there was no pressure on the blood vessels of the resected intestine. Taking into account the recommendations mentioned above, 3 surgical operations were performed. But after the operation, the period during which various biliary complications are formed has not yet passed, so we consider it too early to discuss the usefulness of the proposed practical recommendations.