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Intraoperative Real-Time Cholangiography and C-tube Drainage in Donor Hepatectomy Reduce Biliary Tract Complications

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

In living-donor liver transplantation, biliary tract complications are a serious problem for recipients and donors.

Methods

We applied intraoperative real-time cholangiography using a C-arm and/or C-tube drainage to reduce biliary tract complications in donor hepatectomy. From 2003 to 2010, intraoperative real-time cholangiography and C-tube drainage was applied to 39 and 19 donor cases, respectively. Fifteen donor cases had both procedures.

Results

We confirmed the division line of the hepatic duct by visualizing a stricture on the monitor of the C-arm by pulling a thread and dissecting the proper site of the bile duct. The number of hepatic ducts of the graft to be anastomosed was 1 in 11 cases and 2 or 3 in 8 of the 19 cases without intraoperative real-time cholangiography, and it was 1 in 32 cases and 2 in 7 of the 39 cases with intraoperative real-time cholangiography. Bile leakage from the resection occurred in seven donors without, and in none of those with, C-tube drainage.

Conclusion

In living-donor liver transplantation, intraoperative real-time cholangiography enables effective determination of the precise division line of the hepatic duct. Moreover, C-tube drainage is effective for reducing bile leakage from the resected surface of the liver of donors.

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Abbreviations

LDLT:

Living-donor liver transplantation

IORTC:

Intraoperative real-time cholangiography

CBD:

Common bile duct

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Authors and Affiliations

  1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Toshiya Ochiai, Hisashi Ikoma, Koji Inoue, Yasutoshi Murayama, Shuhei Komatsu, Atsushi Shiozaki, Yoshiaki Kuriu, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Yukihito Kokuba, Teruhisa Sonoyama & Eigo Otsuji

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  1. Toshiya Ochiai
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  2. Hisashi Ikoma
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  3. Koji Inoue
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  4. Yasutoshi Murayama
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  5. Shuhei Komatsu
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  6. Atsushi Shiozaki
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  7. Yoshiaki Kuriu
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  8. Masayoshi Nakanishi
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  9. Daisuke Ichikawa
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  10. Hitoshi Fujiwara
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  11. Kazuma Okamoto
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  12. Yukihito Kokuba
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  13. Teruhisa Sonoyama
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  14. Eigo Otsuji
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Correspondence to Toshiya Ochiai.

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Ochiai, T., Ikoma, H., Inoue, K. et al. Intraoperative Real-Time Cholangiography and C-tube Drainage in Donor Hepatectomy Reduce Biliary Tract Complications. J Gastrointest Surg 15, 2159–2164 (2011). https://doi.org/10.1007/s11605-011-1681-9

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  • DOI: https://doi.org/10.1007/s11605-011-1681-9

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