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- Publisher Website: 10.1016/S1499-3872(13)60004-1
- Scopus: eid_2-s2.0-84874239775
- PMID: 23392797
- WOS: WOS:000314792800004
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Article: Outcomes of side-to-side conversion hepaticojejunostomy for biliary anastomotic stricture after right-liver living donor liver transplantation
Title | Outcomes of side-to-side conversion hepaticojejunostomy for biliary anastomotic stricture after right-liver living donor liver transplantation |
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Authors | |
Keywords | Biliary anastomotic stricture Living donor liver transplantation Right-liver Hepaticojejunostomy Endoscopic treatment Duct-to-duct anastomosis |
Issue Date | 2013 |
Citation | Hepatobiliary and Pancreatic Diseases International, 2013, v. 12, n. 1, p. 42-46 How to Cite? |
Abstract | BACKGROUND: Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture, a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis, after failed endoscopic treatment. The aim of this study is to compare the outcomes of side-to-side hepaticojejunostomy with those of end-to-side hepaticojejunostomy. METHODS: Prospectively collected data of 402 adult patients who had undergone right-liver living donor liver transplantation with duct-to-duct anastomosis were reviewed. Diagnosis of biliary anastomotic stricture was made based on clinical, biochemical, histological and radiological results. Endoscopic treatment was the first-line treatment of biliary anastomotic stricture. RESULTS: Interventional radiological or endoscopic treatment failed to correct the biliary anastomotic stricture in 13 patients, so they underwent conversion hepaticojejunostomy. Ten of them received end-to-side hepaticojejunostomy and three received side-to-side hepaticojejunostomy. In the end-to-side group, two patients sustained hepatic artery injury requiring repeated microvascular anastomosis, two developed re-stenosis requiring further percutaneous transhepatic biliary drainage and balloon dilatation, and two required revision hepaticojejunostomy. In the side-to-side group, one patient developed re-stenosis requiring further endoscopic retrograde cholangiography and balloon dilatation. No re-operation was needed in this group. Otherwise, outcomes in the two groups were similar in terms of liver function and graft survival. CONCLUSIONS: Despite the similar outcomes, side-to-side hepaticojejunostomy may be a better option for bile duct reconstruction after failed interventional radiological or endoscopic treatment because it can decrease the chance of hepatic artery injury and allows future endoscopic treatment if re-stricture develops. However, more large-scale studies are warranted to validate the results. © 2013, Hepatobiliary Pancreat Dis Int. |
Persistent Identifier | http://hdl.handle.net/10722/221335 |
ISSN | 2023 Impact Factor: 3.6 2023 SCImago Journal Rankings: 0.720 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chok, KSH | - |
dc.contributor.author | Chan, SC | - |
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Sharr, WW | - |
dc.contributor.author | Fan, ST | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2015-11-18T06:09:02Z | - |
dc.date.available | 2015-11-18T06:09:02Z | - |
dc.date.issued | 2013 | - |
dc.identifier.citation | Hepatobiliary and Pancreatic Diseases International, 2013, v. 12, n. 1, p. 42-46 | - |
dc.identifier.issn | 1499-3872 | - |
dc.identifier.uri | http://hdl.handle.net/10722/221335 | - |
dc.description.abstract | BACKGROUND: Conversion hepaticojejunostomy is considered the salvage intervention for biliary anastomotic stricture, a common complication of right-liver living donor liver transplantation with duct-to-duct anastomosis, after failed endoscopic treatment. The aim of this study is to compare the outcomes of side-to-side hepaticojejunostomy with those of end-to-side hepaticojejunostomy. METHODS: Prospectively collected data of 402 adult patients who had undergone right-liver living donor liver transplantation with duct-to-duct anastomosis were reviewed. Diagnosis of biliary anastomotic stricture was made based on clinical, biochemical, histological and radiological results. Endoscopic treatment was the first-line treatment of biliary anastomotic stricture. RESULTS: Interventional radiological or endoscopic treatment failed to correct the biliary anastomotic stricture in 13 patients, so they underwent conversion hepaticojejunostomy. Ten of them received end-to-side hepaticojejunostomy and three received side-to-side hepaticojejunostomy. In the end-to-side group, two patients sustained hepatic artery injury requiring repeated microvascular anastomosis, two developed re-stenosis requiring further percutaneous transhepatic biliary drainage and balloon dilatation, and two required revision hepaticojejunostomy. In the side-to-side group, one patient developed re-stenosis requiring further endoscopic retrograde cholangiography and balloon dilatation. No re-operation was needed in this group. Otherwise, outcomes in the two groups were similar in terms of liver function and graft survival. CONCLUSIONS: Despite the similar outcomes, side-to-side hepaticojejunostomy may be a better option for bile duct reconstruction after failed interventional radiological or endoscopic treatment because it can decrease the chance of hepatic artery injury and allows future endoscopic treatment if re-stricture develops. However, more large-scale studies are warranted to validate the results. © 2013, Hepatobiliary Pancreat Dis Int. | - |
dc.language | eng | - |
dc.relation.ispartof | Hepatobiliary and Pancreatic Diseases International | - |
dc.subject | Biliary anastomotic stricture | - |
dc.subject | Living donor liver transplantation | - |
dc.subject | Right-liver | - |
dc.subject | Hepaticojejunostomy | - |
dc.subject | Endoscopic treatment | - |
dc.subject | Duct-to-duct anastomosis | - |
dc.title | Outcomes of side-to-side conversion hepaticojejunostomy for biliary anastomotic stricture after right-liver living donor liver transplantation | - |
dc.type | Article | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1016/S1499-3872(13)60004-1 | - |
dc.identifier.pmid | 23392797 | - |
dc.identifier.scopus | eid_2-s2.0-84874239775 | - |
dc.identifier.hkuros | 213637 | - |
dc.identifier.volume | 12 | - |
dc.identifier.issue | 1 | - |
dc.identifier.spage | 42 | - |
dc.identifier.epage | 46 | - |
dc.identifier.isi | WOS:000314792800004 | - |
dc.identifier.issnl | 2352-9377 | - |