It is unclear whether presence of multiple bile ducts in the graft increases the risk of biliary complications after living-donor liver transplant (LDLT). Since September 2001, 238 liver transplants have been done in 234 recipients at our center. After December 2006, we did not use a drainage catheter (e.g., T tube) for bile duct reconstruction; since that time, 79 LDLTs have been performed at our center. Twenty-seven of these 79 recipient’s (19 male, 8 female; 19 adults; 8 children; mean age, 22 years) graft had multiple bile ducts, which were analyzed 30.9 retrospectively. Biliary reconstruction was done with a duct-to-duct anastomosis in 21 recipients and with a Roux-en-Y hepaticojejunostomy in 6. Twenty-two of the 27 grafts had 2 bile ducts, 4 had 3 bile ducts, and 1 had 4 bile ducts. In 4 grafts with 2 bile ducts, we made separate anastomoses. In the remaining 18 grafts with 2 bile ducts, we created a single orifice at the back table. In 2 grafts with 3 bile ducts, the 2 neighboring ducts were sutured together; the other bile duct was anastomosed separately. In the remaining 2 grafts with 3 bile ducts, the 3 bile ducts were sutured together. In the last graft with 4 bile ducts, 2 neighboring ducts were sutured together; the remaining 2 bile ducts were anastomosed separately. Three biliary leaks and 1 biliary stenosis occurred in this series; these were successfully treated with interventional 6.3 months and at the time of thisradiology. At a mean follow-up of 9.6 writing, 3 recipients had died, and the remaining 24 (89%) recipients were alive with normal liver functioning. In conclusion, Although the follow-up in our series was short, it appears that the presence of more than 1 bile duct in a graft did not increase biliary complications after liver transplant.
Volume : 6
Issue : 4
Pages : 24
Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey