Shirouzu Yasumasa, Okajima Hideaki, Ogata Satsuki, Ohya Yuki, Tsukamoto Yukika, Yamamoto Hidekazu, Takeichi Takayuki, Kwang-Jong Lee, Asonuma Katsuhiro, Inomata Yukihiro
Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Liver Transpl. 2008 Dec;14(12):1761-5. doi: 10.1002/lt.21599.
Hepaticojejunostomy is a standard biliary reconstruction method for infantile living donor liver transplantation (LDLT), but choledochocholedochostomy for infants is not generally accepted yet. Ten pediatric recipients weighing no more than 10 kg underwent duct-to-duct choledochocholedochostomy (DD) for biliary reconstruction for LDLT. Patients were followed up for a median period of 26.8 months (range: 4.0-79.0 months). The incidence of posttransplant biliary complications for DD was compared with that for Roux-en-Y hepaticojejunostomy (RY). No DD patients and 1 RY patient (5%) developed biliary leakage (P > 0.05), and biliary stricture occurred in 1 DD patient (10%) and none of the RY patients (P > 0.05); none of the DD patients and 5 RY patients (25%) suffered from uncomplicated cholangitis after LDLT (P > 0.05), and 1 DD patient (10%) and 2 RY patients (10%) died of causes unrelated to biliary complications. In conclusion, both hepaticojejunostomy and choledochocholedochostomy resulted in satisfactory outcome in terms of biliary complications, including leakage and stricture, for recipients weighing no more than 10 kg.
肝空肠吻合术是婴幼儿活体肝移植（LDLT）标准的胆道重建方法，但婴幼儿胆总管对端吻合术尚未被广泛接受。10例体重不超过10kg的儿童受体接受了胆总管对端吻合术（DD）用于LDLT的胆道重建。对患者进行了中位时间为26.8个月（范围：4.0 - 79.0个月）的随访。将DD术后移植后胆道并发症的发生率与 Roux - en - Y 肝空肠吻合术（RY）的发生率进行比较。DD组无患者发生胆漏，RY组有1例患者发生胆漏（5%）（P > 0.05）；DD组有1例患者（10%）发生胆道狭窄，RY组无患者发生胆道狭窄（P > 0.05）；DD组无患者发生单纯性胆管炎，RY组有5例患者（25%）发生单纯性胆管炎（P > 0.05）；DD组有1例患者（10%）和RY组有2例患者（10%）死于与胆道并发症无关的原因。总之，对于体重不超过10kg的受体，肝空肠吻合术和胆总管对端吻合术在包括胆漏和狭窄在内的胆道并发症方面均取得了满意的结果。
