Retrospective Analysis of Using the Modified in Pediatric Recipients of Left Lateral Segment Liver Graft

Abstract

Purpose Transplantation of the left lateral section of liver from a living related donor is an effective method of treatment of end stage liver diseases in children. At the same time, the biliary reconstruction remains relevant to this day.The frequency of biliary complications reaches 45%according to world literature. Methods from January 2009 to October 2017 420 left lateral section transplantation in children aged from 4 to 12 months, with body mass from 5 up to 16 kg were performed. There were 404 living related donor and 16 split transplantations. Standard Roux-en-Y procedure for biliary end to side reconstruction with interrupted stitches with PDS 5/0 or 6/0 was used before 2013. Since 2013 a new technique of biliary reconstruction using round ligament of graft for peritonization of biliodigestive anastomosis with several interrupted stitches was proposed. A comparative analysis was carried out by retrospective compare is on two groups of patients: group A (2009-2012) n = 168 with classical Roux-en-Y procedure for biliary reconstruction, and group B (2013-2017) n = 252 with a new method of biliary reconstruction. Results Biliary complication rate was 14,7% in group A (biliary fistula 12,5%, biliary leakage 0.5%, stricture 1.7%). Rate of biliary complications was 9% in group B (biliary fistula 7,5%, biliary leakage 0,2%, stricture 1,3%). Conclusion The proposed surgical technique allows to reduce the amount of biliary complications.