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Öğe Quercetin dose affects the fate of hepatic ischemia and reperfusion injury in rats: An experimental research(Elsevıer scıence bv, po box 211, 1000 ae amsterdam, netherlands, 2018) Uylas, Mustafa UfukBACKGROUND: Quercetin found in fruits and vegetables has an antioxidative effect. We aimed to investigate the protective effects of quercetin according to different doses on hepatic and ischemia-reperfusion (I/R) injury. METHODS: Fifty mature male Sprague-Dawley rats were randomly divided into five groups (n = 10 for each). All the animal groups underwent laparotomy. Group 1 rats served as a sham-operated group. Groups 2-5 underwent 1 h hepatic ischemia and were followed by 2 h reperfusion. Group 3-5 animals received an additional intraperitoneal dose of 25, 50 or 100 mg/kg quercetin respectively before I/R operation. Blood samples were collected for determining serum aspartate transaminase (AST), alanine transaminase (ALT) and malondialdehyde (MDA) levels. Also, liver tissue samples were taken for measuring of liver MDA concentration and for histopathology assessment. RESULTS: The highest levels of biochemical parameters were observed in group 2. In quercetin-treated groups, serum AST, ALT, MDA levels, and tissue MDA concentration were decreased as inversely with increasing quercetin dose. Microscopic evaluation revealed that most conspicuous histological improvement was observed in 50 mg/kg quercetin co-treated rats. 25 and 100 mg/kg quercetin co-treatment could not protect completely against hepatic I/R injury. CONCLUSION: Quercetin can be effective in preventing of hepatic I/R injury when the correct dose was used.Öğe Investigation of the effect of milrinone on renal damage in an experimental non-heart beating donormodel(TAYLOR & FRANCIS INC, 530 WALNUT STREET, STE 850, PHILADELPHIA, PA 19106 USA, 2018) Batcıoğlu, Kadir; Uyumlu, Burçin A.; Karadağ, MehmetPurpose: In our study, it was aimed to investigate the preventive effect of milrinone on renal damage in experimental controlled non-heart-beating donors (NHBDs) model. Materials and Methods: Sixteen rats randomly divided into 2 groups, 8 rats in each were used. Group 1 was control, group 2 was milrinone group. Group 1 rats received 1.25ml 0.09% NaCl intraperitoneally equivalent to the milrinone diluted volume. Group 2 rats were administered intraperitoneally with 0.5mg/kg of milrinone 2hours before cardiac arrest. After the cardiac arrest, left nephrectomy was applied to the rats. Malondialdehyde, superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx) activities, Caspase-3 (apoptotic index) and histopathological evaluation were performed in the tissues. Results: In the milrinone group, the total injury score was significantly lower relative to the control group (p = 0.001). Caspase-3 staining was moderately strong in the control group but weaker in the milrinone group. Apoptotic index was significantly lower in the milrinone group compared to the control group (p = 0.001). In comparison between groups, SOD and GPx in the milrinone group was significantly higher than the control group (p = 0.008, p = 0.006). Conclusions: Milrinone has been shown to be effective in the prevention of tissue damage due to oxidative stress and inflammatory process in the renal of warm ischemia in the experimental NHBDs model and in protecting the renal. Milrinone increases antioxidant activity while reducing apoptosis. Systemic administration of milrinone prior to cardiac arrest may be beneficial. Administration of milrinone to the recipient in the perioperative period may contribute to donor function.Öğe An intrahepatic portal vein aneurysm presenting with esophageal variceal bleeding in a pediatricpatient: a rare clinical entity(GALENOS YAYINCILIK, ERKAN MOR, MOLLA GURANI CAD 21-1, FINDIKZADE, ISTANBUL 34093, TURKEY, 2018) Güngör, Şükrü; Varol, Fatma ilknur; Kutlu, Ramazan; Yılmaz, Sezai; Selimoğlu, Mukadder AyşeÖğe A surgical technique for secondary repair of obstetric anal sphincter injuries; Sphinctero-vagino-perineoplasty(Turkısh journal of obstetrıcs and gynecology, 2018) Şimşek, Arife; Ateş, Mustafa; Dirican, Abuzer; Özgör, DinçerObjective: This study was conducted to present the preliminary results of seven patients treated with sphinctero-vagino-perineoplasty for secondary repair of obstetric anal sphincter injuries. Materials and Methods: This retrospective study was conducted on the records of seven patients who underwent secondary repair of obstetric anal sphincter injuries at the colorectal surgery unit of a tertiary care center between February 2015 and December 2017. Results: All patients with solid stool incontinence were fully recovered at postoperative month 3. The Wexner incontinence score was significantly improved (decreased from 14.12 [range: 8-20] to 2.28 [range: 1-4]). The complication rate was 85.7% (wound infection, abscess, hematoma, detachment). Conclusion: Combined repair of anal sphinchters, perineal body, superficial transverse perineal muscles, and bulbospongious muscles, which contribute to anal continence, may improve surgical outcomes in patients with obstetric anal sphincter injuries.Öğe Urgent revascularization of a liver allograft with a saphenous vein interposition graft between the hepatic artery and the recipient splenic artery after late hepatic artery(Digestive Diseases and Sciences, Vol. 50, No. 6 (June 2005), pp. 1177–1180 ( 2005)., 2005) Yılmaz, Sezai; Kırımlıoğlu, Vedat; Işık, Burak; Yılmaz, Mehmet; Kırımlıoğlu, Hale; Ara, Cengiz; Söğütlü, Gökhan; Battaloğlu, BektaşHepatic artery thrombosis (HAT) after liver transplantation is a severe complication which may lead to graft infarction and subsequent graft loss. It complicates 2–12% of adult liver transplantations (1, 2) and subsequently leads to retransplantation in 50–75% of patients (3). Fortunately, innovations in Doppler ultrasonography and digital angiography technologies have provided an accurate and rapid method for detecting HAT before ischemic damage of the allograft (4). Revascularization procedures that can be performed once the diagnosis of HAT has been confirmed include thrombectomy alone, intrahepatic arterial thrombolysis with thrombolytic agents, creation of a new anastomosis between a more proximal part of the recipient artery and a more distal part of the donor hepatic artery, and introduction of an interposition graft (3). Early diagnosis is a prerequisite for these revascularization strategies.Öğe Spontaneous small bowel perforations due to intestinal tuberculosis should not be repaired by simple closure(J Gastrointest Surg. , 0–0., 2005) Ara, Cengiz; Söğütlü, Gökhan; Yıldız, Ramazan; Koçak, Özcan; Işık, Burak; Kırımlıoğlu, VedatIntestinal tuberculosis is a major problem in many regions of the world. The incidence of it is rising in Western countries due to immigration from Third World countries and human immunodeficiency virus infection. The difference between the simple closure and resection and anastomosis was evaluated in this study. Retrospectively, 12 patients with intestinal tuberculosis diagnosed histopathologically among 50 patients with free intestinal perforations operated on between 1995 and 2003 at Turgut Ozal Medical Center were evaluated. Each patient underwent routine laboratory tests and radiologic studies. The most common symptoms of patients were abdominal pain, night sweats, and weight loss. Sites of perforation were ileum in 10 patients (multiple perforation in 4) and jejunum in 2 patients (both had multiple perforations). The perforation was closed by primary closure in 7 patients. Resection-anastomosis was performed in 5 patients. Leaks occurred in overall 3 of 7 patients with primary closure. Three of the 7 patients with leaks due to septicemia died. The mortality rate among all patients was 25%. Intestinal tuberculosis should be kept in mind as a cause in free intestinal perforations. Because of high mortality rate, the resection of the affected area and anastomosis may be the treatment of choice rather than primary closure.Öğe The effect of caffeic acid phenethyl ester on bacterial translocation and intestinal damage in cholestatic rats(Dig Dis Sci (2006) 51:1754–1760, 2006) Ara, Cengiz; Eşrefoğlu, Mukaddes; Polat, Alaadin; Işık, Burak; Aladağ, Murat; Gül, Mehmet; Ay, Selma; Tekerekoğlu, M.Sait; Yılmaz, SezaiWe investigated the effect of caffeic acid phenethyl ester in rat ileum injury induced by chronic biliary obstruction. Swiss albino rats were divided into three groups: Group 1, sham (n = 7); Group 2, common bile duct ligation (n = 7); and Group 3, common bile duct ligation plus caffeic acid phenethyl ester (n = 7). In the caffeic acid phenethyl ester-treated rats, ileum tissue levels of malondialdehyde and myeloperoxidase were significantly lower than those of the bile duct-ligated rats (P < 0.001). The levels of tumor necrosis factor-α, interleukin-6, and interleukin-1α in the caffeic acid phenethyl ester group were significantly lower than those in the bile duct ligation group (P < 0.03, P < 0.01, and P < 0.02 respectively). The present study demonstrates that intraperitoneal administration of caffeic acid phenethyl ester in bile duct-ligated rats reduces intestinal oxidative stress. This effect may be useful in the preservation of intestinal damage in cholestasis.Öğe Liver pathology and cell proliferation after calcineurin ınhibitors and antiproliferative drugs following partial hepatectomy in rats(Transplantation Proceedings, 38(2), 622–626., 2006) Kırımlıoğlu, Hale; Kırımlıoğlu, Vedat; Yılmaz, Sezai; Çoban, Sacid; Türkmen, Emine; Ara, CengizImmunosuppressants are the cornerstones of treatment after solid organ transplantation. This study investigated the pathology and cell proliferation following partial hepatectomy (PH) in rats undergoing immunosuppressive treatment. After 1 day, all rats were subjected to 70% PH. Groups A and B (n 10) received calcineurin inhibitors subcutaneously: either FK506 or cyclosporine (CyA). Groups C and D (n 10) received antiproliferative drugs: either mycophenolate mofetil (MMF) or sirolimus (SRL) by gavage. A control group (n 5) received 1 mL of tap water daily. On postoperative day 2, all rats were sacrificed to obtain liver tissue for pathologic examination. Using immunohistochemistry we separately examined the hepatectomy surface and the liver parenchyma. In the parenchyma, the Ki-67 indices were higher in the CyA and FK506 groups and lower in the SRL and MMF groups compared with controls (P .01). CyA had the highest and MMF the lowest values. On the hepatectomy surface, Ki-67 indices and TGF-alpha expressions were higher in the CyA group and lower in the SRL and MMF groups compared with the control group (P .01). Slightly higher values in the FK506 group were not significantly different compared with the control group (P .05). All groups other than FK506 showed prominent cholangiolar epithelial phenotypes compared with the control group. In the CyA and SRL groups, the number of cholangiolar cells was higher (P .01), and in the MMF group lower than in the control group (P .01). Among all groups, SRL had the highest values.Öğe Spontaneous ıntestinal perforation due to non hodgkin s lymphoma evaluation of eight cases(Digestive Diseases and Sciences, 52(8), 1752–1756., 2007) Ara, Cengiz; Çoban, Sacid; Kayaalp, Cüneyt; Yılmaz, Sezai; Kırımlıoğlu, VedatAbstract Primary intestinal lymphoma with spontaneous perforation and after systemic chemotherapy is rare. The present study summarizes retrospectively the outcome of eight free intestinal perforated patients diagnosed with intestinal non-Hodgkin’s lymphoma. Two patients had a history of systemic chemotherapy before perforation. The most common symptoms of the patients were abdominal pain, nausea, vomiting, weight loss, and fever. Sites of perforation were ileum in four, jejunum in two, cecum in one, and sigmoid colon in one patient. Synchronous lymphoma was present in three patients. The perforation was closed by primary closure in three patients. Resection/anastomosis was performed in four patients and sigmoid colostomy was performed in one patient. Three patients were lost due to leakage or septicemia. Intestinal lymphoma might be kept in mind as a cause in free intestinal perforations. Because of the high mortality rate early diagnosis and treatment are important to improve the prognosis of bowel perforation in patients with non-Hodgkin’s lymphoma.Öğe Duodeno sigmoid fistula due to ingested metallic wire(The Journal of Emergency Medicine, Vol. 34, No. 1, pp. 83–84, 2008., 2008) Yılmaz, Sezai; Işık, Burak; Söğütlü, Gökhan; Ara, Cengiz; Kırımlıoğlu, VedatForeign body ingestion has received extensive coverage in departments of Surgery, Emergency Medicine, and Pediatrics. Most foreign bodies pass through the gastrointestinal tract uneventfully. However, 10% to 20% of the cases are generally managed by endoscopy, and surgical treatment is needed in less than 1% of cases (1). A total of 1500–1600 deaths occur annually in the United States as a result of foreign body ingestion or insertion (2). The problem is encountered in all age groups; however, it is more common in the pediatric age group, and the peak incidence is between ages 6 months and 6 years (3). Foreign body ingestion is rare in adults and usually occurs accidentally or in those with psychiatric problems, behavioral disorders, emotional disturbance, mental retardation, or impaired judgment caused by alcohol use (4). We present a case of a duodeno-sigmoid fistula due to metallic wire ingestion by a mentally disabled man.Öğe Kaposi s sarcoma after liver transplantation from a donor with a history of ventriculoperitoneal shunt and craniotomy for primary central nervous system lymphoma report of a case(Surg Today (2008) 38:90–94, 2008) Işık, Burak; Yılmaz, Sezai; Kırımlıoğlu, Vedat; Kırımlıoğlu, Vedat; Yılmaz, Sezai; Söğütlü, Gökhan; Ara, CengizAbstract The transplantation of organs from donors who have undergone shunt surgery or craniotomy for a malignant central nervous system (CNS) tumor is controversial. We report a case of Kaposi’s sarcoma (KS) developing as a result of immunosuppression in the recipient of a liver transplant from a donor who underwent craniotomy and ventriculoperitoneal shunt surgery for primary CNS lymphoma. Polymerase chain reaction assay did not isolate human herpes virus-8 in the Kaposi lesions. To our knowledge, this is the only case ever reported of KS developing after liver transplantation from a donor with lymphoma. Thus, with appropriate screening to exclude possible dissemination, patients with a history of high-grade primary CNS lymphoma treated by ventriculoperitoneal shunt and craniotomy may be accepted as donors.Öğe A case of acute small bowel obstruction due to metastasis of undiagnosed primary carcinoma of the lung(Turk J Gastroenterol., 0–0., 2009) Ara, Cengiz; Dirican, Abuzer; Özgör, Dinçer; Pişkin, TurgutA 75-year-old man was admitted to our department with abdominal pain, nausea and vomiting. He was a heavy smoker (a packet/day/60 years) with chronic obstructive pulmonary disease.Öğe Torsion of wandering spleen(Bratisl Lek Listy. 2009;110(11):723-5., 2009) Dirican, Abuzer; Işık, Burak; Ara, Cengiz; Ünal, Bülent; Özgör, Dinçer; Meydanlı, Mehmet MutluWandering spleen is characterized by ectopic localization of spleen owing to the lack or weakening of the major splenic ligaments. In present study, two cases with torsion of wandering spleen were reported. The first case was a 30-year-old female who was admitted to emergency department with acute abdominal pain and vomiting. Abdominal Ultrasonography and computed tomography showed a round solid hypodense mass that was located in the left hypochondriac region of abdomen. At laparotomy, the patient was found to have torsion of a wandering spleen with complete infarction and pancreatic tail infarction. Splenectomy and distal pancreatectomy were performed. The second patient was a 19-year-old female. She was admitted to emergency department with abdominal pain. Axial computed tomography (CT) showed pelvic mass that indicated a possibility of a wandering spleen. The wandering spleen was removed with its long pedicle because of infarction. Torsion of wandering spleen must be considered in differential diagnosis of acute abdomen when a palpable painful abdominal mass is present on physical examination, and the spleen is absent in its normal anatomical location on radiological examination (Fig. 4, Ref. 8). Full Text (Free, PDF) www.bmj.sk.Öğe Melatonin ameliorates tacrolimus FK 506 s induced immunosupressive effect in rat liver(Transplant Proc., 0–0., 2009) Karabulut, Aysun Bay; Ara, CengizTacrolimus (FK-506) is a powerful immunosuppressive agent that modulates neutrophil infiltration during inflammation. In this study, we sought to investigate the effects of melatonin on malondialdehyde (MDA), nitric oxide (NO), interleukin (IL)-6, and tumor necrosis factor-alpha (TNF-alpha) to oppose the negative effects of the immunosupressant FK-506. Group A was sham; group B, tacrolimus (1 mg/kg/d subcutaneously); and Group C received tacrolimus (1 mg/kg/d plus melatonin). All tissues underwent histopathologic examination. The MDA level in group B increased 53% compared with the sham group (P .001); in group C, the MDA level decreased 16% compared with group B (P .05). While TNF-alpha in group B increased 68.8% compared with the sham group (P .001) and in group C it decreased 63.5% compared with the sham group. The IL-6 level in group B increased 81%; in group C, it decreased 13% compared with group B. NO levels in group B increased 48% compared with the sham group and increased by 15% in group B compared with group C. Thus melatonin may serve as a protective agent against the side effects of tacrolimus.Öğe The effect of caffeic acid phenethyl ester on bacterial translocation and intestinal damage after intestinal obstruction(Turk J Med Sci 2010; 40 (6): 897-903., 2010) Ara, Cengiz; Dirican, Abuzer; Erdoğan, Selim; Ateş, Burhan; Özgör, Burhan; Tatlı, Faik; Tekerekoğlu, M.SaitAim: Intestinal obstruction (IO) induces bacterial translocation due to failure of the intestinal barrier function. Following bacterial overgrowth, its degradation products play a decisive role in the development of systemic septic complications. The aim of this study was to evaluate the effects of caffeic acid phenethyl ester (CAPE) on bacterial translocation and intestinal damage in an IO model in rats. Materials and methods: Complete IO was created in the distal ileum of rats by a single 4-0 silk suture. A total of 21 Wistar albino rats were randomized into 3 groups: Group 1, Sham (n = 7); Group 2, IO (n = 7); Group 3, IO + CAPE (n = 7). Group 3 received a 10 μmol kg-1 dose of CAPE intraperitoneally. This treatment was continued for 3 days (2 days before surgery and 1 day after surgery). Samples of mesenteric lymph nodes (MLN), liver, and segmental ilea were obtained 24 h after the mechanical bowel obstruction, both for biochemical analysis and microbiological examination. Results: The most common bacteria cultured from the liver and MLN of these animals were Escherichia coli, Proteus mirabilis, and Enterococcus spp. In the CAPE-treated rats, the malondialdehyde (MDA) and adrenomedullin levels were significantly lower than in the IO group (P < 0.001). The reduced glutathione (GSH) and catalase (CAT) levels of the ileum were found to be significantly higher in the CAPE-treated rats than those in the IO group (P < 0.001). Conclusion: These results have shown that CAPE may have protective effects against bacterial translocation and intestinal oxidative damage in mechanical IO. More experimental studies are needed to explain the exact mechanism of this beneficial effect.Öğe Beneficial effect of caffeic acid phenethyl ester CAPE on hepatocyte damage induced by bile duct ligation an electron microscopic examination(Ultrastructural Pathology, 34:273–278, 2010., 2010) Eşrefoğlu, Mukaddes; Ara, CengizRecently the authors have reported the potent beneficial effect of caffeic acid phenethyl ester (CAPE) on cholestatic oxidative liver injury induced by acute bile ligation in Swiss albino rats. Herein, they report the ultrastructural hepatocellular alterations induced by acute bile duct ligation and the effect of CAPE administration on these alterations. Bile duct ligation resulted in many degenerative changes, such as vacuolization, mitochondrial degeneration, endoplasmic reticulum dilatation, and lysosome accumulation within the cytoplasm of hepatocytes. Mitochondrial degeneration was also observed within the cytoplasm of the cells of biliary ductular epithelium. CAPE potentially protected the hepatocytes from the cholestasis-induced cellular injuryÖğe The effect of caffeic acid phenethyl ester CAPE against cholestatic liver injury in rats(J Surg Res, 0–0., 2010) Çoban, Sacid; Yıldız, Fahrettin; Alpaslan, Terzi; Al, Behcet; Özgör, Dinçer; Ara, Cengiz; Ara, Cengiz; Polat, Alaadin; Esrefoğlu, MukaddesObjectives. Caffeic acid phenethyl ester (CAPE) has been subjected to considerable investigations that have revealed its antioxidant and anti-inflammatory activities in different conditions. But there is not a previous investigation about its effect on cholestatic liver injury. The aim of this study was to investigate the effect of CAPE in rat liver against cholestatic liver injury induced by bile duct ligation. Methods. Swiss-albino rats were recruited in the study as follows; Group 1 rats subjected to simple laparotomy known as the sham group; Group 2 rats subjected to bile duct ligation (BDL); Group 3 bile duct ligated rats treated with CAPE. The third group received CAPE (10 mmol/kg) intraperitoneally daily throughout 14 d. Results. Data showed a decrease in g glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase levels (ALT) of the CAPE treated rats, compared with BDL group (P < 0.001, P < 0.01, and P < 0.02, respectively). In the CAPE treated rats, tissue levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were significantly lower than that of the BDL group (P < 0.001). The levels of glutathione (GSH) in CAPE treated rats were significantly higher than that of BDL group (P < 0.001). In CAPE treated group, the levels of interleukin1alpha (IL-1a) and interleukin-6 (IL-6) were signifi- cantly lower than that of BDL group (P < 0.03, P < 0.02, respectively). Administration of CAPE in the rats with biliary obstruction resulted in inhibition of necro-inflammation. Conclusion. These results suggest that treatment of CAPE maintains antioxidant defenses, reduces oxidative liver injury, cytokine damage, and necroinflammation in bile duct ligated rats. Thus, CAPE seems to be a promising agent for the attenuation of cholestatic liver injury. 2010 Elsevier Inc. All rights reserved.Öğe The effect of melatonin against FK506 induced renal oxidative stress in rats(The effect of melatonin against FK506 induced renal oxidative stress in rats, 2011) Ara, Cengiz; Dirican, Abuzer; Ünal, Bülent; Karabulut, Aysun Bay; Pişkin, TurgutBackground: Nephrotoxicity is an important side effect of FK506 and oxidative stress has been considered as one of the possible mechanisms. The present investigation examines the ability of melatonin to protect against FK506-induced renal oxidative stress. Methods: Thirty rats were divided into 3 groups (n = 10 each group). Group A was the sham group. Group B received 14 days FK506 (5 mg/kg/d, intraperitoneally [i.p.]) and group C received FK506 (5 mg/kg/d, i.p.) together with melatonin (4 mg/kg, i.p.) for 14 days. Kidney tissues were harvested to determine the tissue levels of malondialdehyde (MDA), total nitrite and nitric oxide (NO), tumor necrosis factor-a (TNF-a), and interleukin-6 (IL-6). Results: In group C, the levels of TNF-a, IL-6, and NO were lower than in the group B (P < .01, P < .03, and P < .04, respectively) and although MDA levels were lower than in group B, the differences were not statistically significant (P > .05). Conclusion: These results suggest that melatonin has protective effect against FK506-induced renal oxidative stress.Öğe Living donor liver transplantation for acute liver failure in pediatric patients caused by the ingestion of fireworks containing yellow phosphorus(Lıver Transplantatıon 17:1286-1291, 2011., 2011) Ateş, Mustafa; Dirican, Abuzer; Özgör, Dinçer; Aydın, Cemalettin; Işık, Burak; Ara, CengizYellow phosphorus is a protoplasmic toxicant that targets the liver. The ingestion of fireworks containing yellow phosphorus,either by children who accidentally consume them or by adults who are attempting suicide, often results in death due toacute liver failure (ALF). We present the outcomes of 10 children who ingested fireworks containing yellow phosphorus.There were 6 boys and 4 girls, and their ages ranged from 21 to 60 months. One patient remained stable without liver com-plications and was discharged. Three patients died of hepatorenal failure and cardiovascular collapse, and living donor livertransplantation (LDLT) was performed for 6 patients. The patients had grade II or III encephalopathy, a mean alanine amino-transferase level of 1148.2 IU/L, a mean aspartate aminotransferase level of 1437.5 IU/L, a mean total bilirubin level of 6.9mg/dL, a mean international normalized ratio of 6.6, a mean Pediatric End-Stage Liver Disease score of 33.7, and a meanChild-Pugh score of 11.3. Postoperatively, 2 patients had persistent encephalopathy and died on the second or third postop-erative day, and 1 patient died of cardiac arrest on the first postoperative day despite a well-functioning graft. The other 3patients were still alive at a mean of 204 days. In conclusion, the ingestion of fireworks containing yellow phosphoruscauses ALF with a high mortality rate. When signs of irreversible ALF are detected, emergency LDLT should be consideredas a lifesaving procedure; however, if yellow phosphorus toxicity affects both the brain and the heart in addition to the liver,the mortality rate remains very high despite liver transplantation. Liver Transpl 17:1286-1291, 2011.VC2011 AASLD.Öğe Biliary complications in 106 consecutive duct to duct biliary reconstruction in right lobe living donor liver transplantation performed in 1 year in a single center a new surgical technique(Transplant Proc, pp. 0–0, Apr. 2011., 2011) Kırımlıoğlu, Vedat; Tatlı, Faik; İnce, Volkan; Aydın, Cemalettin; Ersan, Veysel; Ara, Cengiz; Aladağ, Murat; Kutlu, Ramazan; Kırımlıoğlu, Hale; Yılmaz, SezaiABSTRACT 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%.
