Biliary complications in adult living donor liver transplantation with duct-to-duct hepaticocholedochostomy or Roux-en-Y hepaticojejunostomy biliary reconstruction

Background. The aim of this study was to compare the incidence of biliary complications after adult livin g donor liver transplantation (ALDLT) with Roux-en-Y hepaticojejunostomy (R-Y HJ) or duct-to-duct hepaticocholedochostomy (D-D HC). Methods. Biliary complications were reviewed in 20 consecutive ALDLT recipients surviving)note, than I month, including 10 patients who underwent R-Y HJ and 10 patients who underwent D-D HC reconstructions. Results. Ten biliary complications were seen in 8 patients (40%) from the study group. Specifically, I case of biliary leakage and I case of biliary hemorrhage were were observed in the R-Y HJ group (20%), and 2 biliary leakages, 4 biliary structures, and 2 C-tube related biliary leakages were seen in 6 patients from the D-D HC group (60%). Three of the 5 patients (60%) who underwent right lobe graf t ALDO experienced biliary structure. All cases of biliary leakage and biliary hemorrhage were stopped spontaneously by continuous drainage. Three patients in the D-D HC group with anastomotic structures were successfully treated with percutaneous interventions. Only I patient with anastomotic structure in the D-D HC group with left lobe graft required intrahepatic R-Y HJ reanastomosis. Two cases of C-tube related biliary leakages were treated with endoscopic management Conclusions. Biliary complications such (is anastomotic structures were common in the D-D HC group rather than in the R-Y HJ group. D-D HC reconstruction should be applied cautiously, especially in the tight lobe graft. ALDLT cases.