Aydın Osman, Turan Gökçe Dilara, Öter Volkan, Arı Derya, Özgün Yiğit Mehmet, Pişkin Erol, Çolakoğlu Muhammet Kadri, Akdoğan Kayhan Meral, Bostancı Erdal Birol
From the Department of Gastrointestinal Surgery, Ankara City Hospital, Ankara, Turkey.
Exp Clin Transplant. 2023 Feb;21(2):139-142. doi: 10.6002/ect.2022.0353.
The most frequent postoperative morbidity following living donor liver transplant is biliary complications, which can happen for both anatomical and procedural reasons.
We conducted a retrospective analysis of 104 patients who were living liver donors undergoing hepatectomy from January 2011 to April 2022. We evaluated all perioperative finding such as age, sex, remnant liver volume, biliary anatomy, theduration of operation time and hospitalization, and blood loss.
Clavien-Dindo classification grade III complications were observed in 24% of all donors, with rate of biliary complications of 7.6% (n = 8). All biliary complications were typified as biliary leakage, and an endoscopic retrograde cholangiopancreatography procedure was performed for 5 patients. We analyzed the clinical and surgical features and discovered that the duration of hospitalization was longer in the biliary leakage group than the group without leakage (15.7 ± 5.8 days vs. 30.8 ± 9.3 days, respectively; P < .08). There was no significant statistical relationship between age, the duration of operation time, intraoperative blood loss, and remnant liver volume versus biliary leakage (P = .074, P = .217, P = .219, and P = .363, respectively).
Early detection and treatment of complications are ensured during the perioperative process by carefuldonor selection andaccurate identification of the patient atrisk for biliary complications.
活体供肝肝移植术后最常见的并发症是胆道并发症，其发生既有解剖学原因，也有手术操作原因。
我们对2011年1月至2022年4月期间接受肝切除术的104例活体肝供者进行了回顾性分析。我们评估了所有围手术期指标，如年龄、性别、残余肝体积、胆道解剖结构、手术时间和住院时间以及失血量。
所有供者中24%观察到Clavien-Dindo分类III级并发症，胆道并发症发生率为7.6%（n = 8）。所有胆道并发症均表现为胆漏，5例患者接受了内镜逆行胰胆管造影术。我们分析了临床和手术特征，发现胆漏组的住院时间比无胆漏组更长（分别为15.7±5.8天和30.8±9.3天；P <.08）。年龄、手术时间、术中失血量和残余肝体积与胆漏之间无显著统计学关系（P分别为.074、.217、.219和.363）。
通过仔细选择供者并准确识别有胆道并发症风险的患者，在围手术期确保对并发症进行早期检测和治疗。
