Introduction: The rate of biliary complication after liver transplantation remains high. The choice of biliary reconstruction technique may depend on the patient's primary disease, possible size difference between the recipient and donor bile duct, as well as prior biliary surgery.

Aim of the study: To analyze the impact of biliary duct reconstruction technique on the development of biliary complications after liver transplantation.

Materials and methods: We retrospectively reviewed 85 patients after full-size liver transplantation between August 1, 2015 to April 1, 2017. Biliary reconstruction was performed by either side-to-side (SS) or end-to-end (EE) anastomosis. Biliary complications, anastomotic stenosis, bile leak, acute rejection rate, and readmission within 90 days after surgery were evaluated by review of our patient records, corresponding radiologic imaging, and reports of interventional (ERCP, PTC) or surgical procedures. In case of biliary complication, patients were assigned to different complication-groups and subsequently reviewed in detail.

Results: A total of 85 patients (age: 57(19-72)), were included in this study. The median follow-up was 7 months. 54 (61.3%) patients had EE biliary anastomosis, whereas 31(38.7%) patients had SS biliary anastomosis. In patients who had SS biliary anastomosis, MELD score at the time of transplant was 28, whereas in patients who had EE biliary anastomosis MELD score at transplantation was 24 (p=0.030). The overall biliary complication rate was 12.9% (n = 11). 2(6.5%) patients from the SS anastomosis group had biliary leakage, whereas 3 (5.6%) patients from the EE anastomosis had leakage, but this difference was not statistically significant (p=0.34). A similar trend was observed in biliary stricture formation. An episode of acute rejection was observed in 4 patients (7.4%) with EE biliary anastomosis, but only 2 patients (6.5%) with SS biliary anastomosis (p=1.00). Readmission rate within 90 days after LT was similar (50.0% and 54.8% (p=ns)) in EE and SS biliary anastomosis groups respectively.

Conclusion: Our study shows that biliary reconstruction technique have no impact on the development of biliary complications in short time period following liver transplantation.

CITATION INFORMATION: Shahbazov R., Kessel M., Knapp K., Azari F., Tsutsui S., Nickkholgh A., Maluf D., Pelletier S. Does Biliary Duct Reconstruction Technique Impact Liver Transplantation Outcomes? Am J Transplant. 2017;17 (suppl 3).

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