05 January 2022 : Original article
Reconstruction of Separated Intrahepatic Ducts Using the Cystic and Common Hepatic Ducts in Right-Lobe Living-Donor Liver Transplantation: Experiences of Surgical Techniques, Biliary Complications, and Outcomes in a Single Institution
Po-Jung Hsu1ABCDEF, Hao-Chien Hung12ABCDEF, Ching-Sung Lee3A, Kuang-Tse Pan4A, Jin-Chiao Lee32A, Yu-Chao Wang32A, Chih-Hsien Cheng32A, Tsung-Han Wu32A, Chen-Fang Lee32A, Hong-Shiue Chou32A, Kun-Ming Chan32A, Wei-Chen Lee32A, Ting-Jung Wu12ACDEF*DOI: 10.12659/AOT.934459
Ann Transplant 2022; 27:e934459
Table 1 Characteristics of enrolled patients after right-lobe living-donor liver transplantation with dual-ductal biliary reconstruction.
| Characteristic | Total case number=56 |
|---|---|
| Age, years | 30.7 (18.5–54.2);32.2±9.5 |
| Sex, male | 35 (62.5%) |
| BMI | 22.9 (18.2–30.8);23.2±0.38 |
| Biliary anatomic type, N* | |
| 1 | 5 (8.9%) |
| 2 | 5 (8.9%) |
| 3b | 3 (5.4%) |
| 4a | 6 (10.7%) |
| 4b | 37 (66.1%) |
| ABO incompatible | 13 (23.2%) |
| GRWR | 0.9 (0.51–1.49);0.95±0.21 |
| Age, years | 53.9 (32.4–70.2);53.7±8.1 |
| Sex, male | 45 (80.4%) |
| MELD | 15.5 (7–40);17.6±9.1 |
| BMI | 25.7 (15.8–43.1);26±4.3 |
| HCC | 24 (42.9%) |
| HBV | 31 (55.4%) |
| HCV | 14 (25%) |
| Warm ischaemia time (mins) | 35.5 (17–58);36.6±8.5 |
| Cold ischaemia time (mins) | 44.5 (18–246);63.0±44.1 |
| Dual ductal biliary reconstruction time (mins) | 71.0 (22.0–150.0);72.3±21.3 |
| Blood loss (mL) | 1525 (200–18500);2193.6±2572.4 |
| Pre-OP bilirubin T (mg/dL) | 2.5 (0.3–34.6);6.4±9.1 |
| Biliary reconstruction | |
| Type A | 44 (78.6%) |
| Type B | 12 (21.4%) |
| Biliary complication | |
| Biliary leakage only | 4 (7.1%) |
| Biliary leakage then stricture | 4 (7.1%) |
| Delay biliary anastomosis stricture | 14 (25.0%) |
| Non-anastomosis biliary stricture (associated with chronic antibody mediated rejection) | 1 (1.8%) |
| Overall biliary complication | 23 (41.1%) |
| Biliary complication free (months) | 12.4 (0.1–165.7);29.9±37.2 |
| Complication duration (months) | 10.4 (0.2–31.4);10.2±7.9 |
| Complication-free, N** | 50 (89.3%) |
| 1-year survival rate | 85.6% |
| 5-year survival rate | 68.8% |
| Follow-up (months) | 46.4 (0.1–178.0);54.1±44.2 |
| Biliary complication rate in two eras | |
| Year 2004–2014 | 17/35 (48.6%) |
| Year 2015–2018 | 6/21 (28.6%) |
| BMI – body mass index; GRWR – graft-to-recipient weight ratio; MELD – Model for End-Stage Liver Disease; HCC – hepatocellular carcinoma; HBV – hepatitis B; HCV – hepatitis C; CBD – common bile duct; bilirubin T – total bilirubin. * According to , 2 edition. ** Accessed at the end of the present study. Data was record as median (range) and mean±standard deviation, or number (%). | |