Abstract:
Objective. Biliary complications remain a major source of morbidity after living donor
liver transplantation (LDLT). Of 109 consecutive right lobe (RL)-LDLTs performed in 1
year in our institution, we present the biliary complications among 106 patients who
underwent a new duct-to-duct anastomosis technique known as University of Inonu.
Methods. Of 153 liver transplantations performed in 1 year from January to December
of 2008, 128 were LDLTs including 109 RL-LDLTs. The others were left or left lateral
grafts. All RL-LDLT patients were adults, all of whom except three included a duct-toduct
anastomosis.
Results. All, but three, biliary reconstructions were completed with a surgical technique,
so called UI, in which 6-0 prolene sutures were used. Nine bile leaks were seen in 106
recipients (8.49%) performed in a duct-to-duct fashion in a time period of 1 to 4 weeks.
Seventeen patients (16.03%) posed bile duct stricture (BDS). Five patients had both.
Although endoscopic stent placement and percutaneous balloon dilatation, 4 patients
continued to suffer from BDS on whom a permanent access hepatico-jejunostomy (PAHJ)
procedures were performed.
Conclusion. We recommend a duct-to-duct biliary reconstruction because of its de facto
advantages over other types of anastomosis provided the native duct is not diseased. After
almost 2 years, the bile tract complication rate was 22.64%.
