Telescopic Biliary Reconstruction in Patients Undergoing Liver Transplantation With 1-Year Follow-up

• Published in: Transplantation proceedings Vol. 49; no. 3; pp. 562 - 565
• Main Authors: Karakas, S, Sarici, K.B, Ozdemir, F, Ersan, V, Ince, V, Baskiran, A, Kayaalp, C, Kutlu, R, Yilmaz, S
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2017
• Subjects: Anastomosis, Surgical - methods; Anastomotic Leak - etiology; Biliary Tract Surgical Procedures - methods; Case-Control Studies; Common Bile Duct - blood supply; Common Bile Duct - surgery; Female; Follow-Up Studies; Gallbladder - surgery; Graft Survival - physiology; Hepatic Artery - surgery; Humans; Ischemia - etiology; Liver Transplantation - methods; Living Donors; Male; Middle Aged; Mucous Membrane - surgery; Retrospective Studies; Surgery
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2017.01.026

Abstract Background Biliary complications are important during liver transplantation because of their effect on recipient and graft survival, incidence, and the long treatment period. These complications are associated with 50% morbidity and 30% mortality rates in recent studies. One of the most important reasons for biliary anastomosis complications is arterial ischemia. We present the results of our telescopic biliary anastomosis technique performed on the mucosa of the main biliary duct. Patients and Methods Fifty-six cases of telescopic biliary reconstruction were performed in 203 patients during 2015. Fifty cases and 52 patients who underwent standard reconstruction were chosen and compared. All patients had been scanned retrospectively. Statistical analyses were conducted with χ2 and Mann-Whitney U tests for the complications that occurred during the first 3 months. A P value <.05 was considered significant. Results No clinical or demographic differences were detected between the groups. About 90% of both groups were living donor liver transplantation cases. Five (10%) anastomotic leaks occurred in telescopic reconstruction group (n = 50), and 13 (25%) occurred in the standard reconstruction group (n = 52; P  < .05). Conclusion The arterial blood supply is better if the biliary anastomosis is made on the mucosal side of the main biliary duct. Early period anastomotic leaks may decrease significantly.