Yamamoto Hidekazu, Hayashida Shintaro, Asonuma Katsuhiro, Honda Masaki, Suda Hiroko, Murokawa Takahiro, Ohya Yuki, Lee Kwang-Jong, Takeichi Takayuki, Inomata Yukihiro
Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Liver Transpl. 2014 Mar;20(3):347-54. doi: 10.1002/lt.23819.
The indications for duct-to-duct (DD) biliary reconstruction in living donor liver transplantation (LDLT) for small children are still controversial. In this study, the feasibility of DD biliary reconstruction versus Roux-en-Y (RY) biliary reconstruction was investigated in terms of long-term outcomes. Fifty-six children who consecutively underwent LDLT with a weight less than or equal to 10.0 kg were enrolled. Biliary reconstruction was performed in a DD fashion for 20 patients and in an RY fashion for 36 patients. During a minimum follow-up of 2 years, the incidence of biliary strictures was 5.0% in the DD group and 11.1% in the RY group. Cholangitis during the posttransplant period was observed in the RY group only. There were no deaths related to biliary problems. This study shows that DD reconstruction in LDLT for small children (weighing 10.0 kg or less) is a feasible option for biliary reconstruction.
在小儿活体肝移植（LDLT）中，胆管对胆管（DD）胆道重建的适应证仍存在争议。在本研究中，从长期结果方面探讨了DD胆道重建与Roux-en-Y（RY）胆道重建的可行性。纳入了56例连续接受LDLT且体重小于或等于10.0 kg的儿童。20例患者采用DD方式进行胆道重建，36例患者采用RY方式进行胆道重建。在至少2年的随访期间，DD组胆道狭窄发生率为5.0%，RY组为11.1%。仅在RY组观察到移植后胆管炎。没有与胆道问题相关的死亡病例。本研究表明，在小儿（体重10.0 kg及以下）LDLT中，DD重建是一种可行的胆道重建选择。
