Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 13, Issue 6, pp 502–510 | Cite as

Endoscopic treatment of biliary complications after right-lobe living-donor liver transplantation with duct-to-duct biliary anastomosis

  • Shujiro Yazumi
  • Takanobu Yoshimoto
  • Hiroshi Hisatsune
  • Kazunori Hasegawa
  • Masaya Kida
  • Shinsuke Tada
  • Yoshito Uenoyama
  • Junichi Yamauchi
  • Seiji Shio
  • Mureo Kasahara
  • Kohei Ogawa
  • Hiroto Egawa
  • Koichi Tanaka
  • Tsutomu Chiba
Article

Abstract

Background/Purpose

The aims of this study were to characterize the features of the biliary complications that occur after right-lobe living-donor liver transplantation (RL-LDLT) with duct-to-duct biliary anastomosis, and to evaluate the efficacy of treating biliary complications endoscopically.

Methods

The records of 273 consecutive patients who underwent RL-LDLT with duct-to-duct biliary anastomosis from July 1999 through July 2005 at Kyoto University Hospital were reviewed to determine the overall incidence of postoperative biliary complications and the outcome of endoscopic repair of those complications.

Results

Biliary complications occurred in 93 (34.1%) of the patients. These complications were: 80 biliary strictures (75 anastomotic and 5 nonanastomotic) and 16 biliary leakages (5 patients with biliary leakage also had a biliary stricture); most (72%) of the anastomotic strictures were complex (i.e., fork-shaped or trident-shaped). The strictures and leakages were repaired by the endoscopic placement of multiple inside stents above the sphincter of Oddi, and by nasobiliary drainage, respectively. The procedure was successful in repairing 51 (68.0%) of the anastomotic strictures and 8 (50.0%) of the biliary leakages.

Conclusions

Endoscopic stenting of the bile ducts is efficacious in treating biliary complications related to RL-LDLT with duct-to-duct biliary anastomosis and the stenting should be attempted before surgical revision of strictures and leakages.

Key words

Living-donor liver transplantation Duct-to-duct biliary anastomosis Biliary stricture Endoscopic stenting 

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Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Shujiro Yazumi
    • 1
  • Takanobu Yoshimoto
    • 1
  • Hiroshi Hisatsune
    • 1
  • Kazunori Hasegawa
    • 1
  • Masaya Kida
    • 1
  • Shinsuke Tada
    • 1
  • Yoshito Uenoyama
    • 1
  • Junichi Yamauchi
    • 1
  • Seiji Shio
    • 1
  • Mureo Kasahara
    • 2
  • Kohei Ogawa
    • 2
  • Hiroto Egawa
    • 2
  • Koichi Tanaka
    • 2
  • Tsutomu Chiba
    • 1
  1. 1.Department of Gastroenterology and HepatologyKyoto University Graduate School of MedicineKyotoJapan
  2. 2.Department of Transplantation and ImmunologyKyoto University Graduate School of MedicineKyotoJapan

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