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

  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

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.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoinkawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Shujiro Yazumi, Takanobu Yoshimoto, Hiroshi Hisatsune, Kazunori Hasegawa, Masaya Kida, Shinsuke Tada, Yoshito Uenoyama, Junichi Yamauchi, Seiji Shio & Tsutomu Chiba

  2. Department of Transplantation and Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Mureo Kasahara, Kohei Ogawa, Hiroto Egawa & Koichi Tanaka

Authors
  1. Shujiro Yazumi
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  2. Takanobu Yoshimoto
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  3. Hiroshi Hisatsune
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  4. Kazunori Hasegawa
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  5. Masaya Kida
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  6. Shinsuke Tada
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  7. Yoshito Uenoyama
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  8. Junichi Yamauchi
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  9. Seiji Shio
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  10. Mureo Kasahara
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  11. Kohei Ogawa
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  12. Hiroto Egawa
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  13. Koichi Tanaka
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  14. Tsutomu Chiba
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Yazumi, S., Yoshimoto, T., Hisatsune, H. et al. Endoscopic treatment of biliary complications after right-lobe living-donor liver transplantation with duct-to-duct biliary anastomosis. J Hepatobiliary Pancreat Surg 13, 502–510 (2006). https://doi.org/10.1007/s00534-005-1084-y

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  • DOI: https://doi.org/10.1007/s00534-005-1084-y

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