Braşoveanu V, Anghel C, Bacalbaşa N, Ionescu M I, Matei E, Barbu I, Grasu M, Tomescu D, Popescu I
Chirurgia (Bucur). 2014 Jan-Feb;109(1):15-9.
Biliary complications contribute to a high morbidity rate in patients with right lobe liver transplant from a living donor. We retrospectively evaluated biliary reconstructions and complications in a number of recipients with liver transplant from a living donor, in a single center.
A number of 46 patients (23 males and 23 females aged 9-63) received a right lobe liver graft between 2009 and 2013, with the following types of biliary reconstruction:duct-to-duct choledochocholedochal anastomosis (n=24)or Roux-en-Y hepaticojejunoanastomosis, with or without an external transanastomotic biliary stent.
The rate of biliary complications (leakage 15.21%,anastomotic stenosis 4.34%, overall 17.39%) was not statistically significantly influenced by the demographics of the studied lot, by the etiology of the liver disease or by the characteristics of the biliary reconstruction; the only risk factor which showed a statistically significant influence in terms of biliary complications was MELD.
The type and technique of the biliary reconstruction in LDLT should be adapted depending on the anatomy of the biliary tree of both the donor and recipient, as well as the clinical and laboratory findings of the recipient.
在活体供肝右叶肝移植患者中，胆道并发症导致了较高的发病率。我们在单一中心对一批活体供肝肝移植受者的胆道重建及并发症进行了回顾性评估。
2009年至2013年间，46例患者（23例男性和23例女性，年龄9至63岁）接受了右叶肝移植，采用了以下几种胆道重建方式：胆管对胆管胆总管吻合术（n = 24）或 Roux-en-Y 肝空肠吻合术，有无外引流吻合口胆管支架。
胆道并发症发生率（渗漏15.21%，吻合口狭窄4.34%，总体17.39%）在统计学上未受到所研究批次的人口统计学特征、肝脏疾病病因或胆道重建特征的显著影响；在胆道并发症方面显示出统计学显著影响的唯一危险因素是终末期肝病模型（MELD）评分。
活体肝移植中胆道重建的类型和技术应根据供体和受体胆道树的解剖结构以及受体的临床和实验室检查结果进行调整。
