Biliary anastomosis stricture (BAS) is still major concerns especially for living donor liver transplantation (LDLT). Recent studies have described multiple duct and multiple anastomoses as risk factor for biliary complications.

We compared clinical outcomes with various reconstruction methods for multiple bile duct through retrospective review of 63 recipients who underwent LDLT using right lobe graft at our institution from January 2013 to April 2017; In patients with two adjacent duct, group 1(n=20) received unification ductoplasty and group 2(n=21) received cluster with mucosal eversion technique. Group 3 (n=19) received separate anastomsis because bile ducts were far apart. For three patients with three duct (n=3), one patient received cluster with eversion technique and others received combined ductoplasty and separate reconstruction technique. All biliary reconstructions were achieved with only duct-to-duct reconstruction. The incidence of biliary leakage and stricture were 9.5% and 7.9% and these results were compared to those in single duct group during same period (p>0.05). In subgroup analysis of patients with two adjacent bile duct, the incidence of BAS in group 2 was lower than that in group 1 (15.0% vs. 4.8%) even though there was no significant difference.

In conclusion, the suitable application of various biliary reconstruction techniques could be a key for minimizing BAS in LDLT with multiple bile ducts and cluster with mucosal eversion technique could be an effective alternative technique to ductoplasty.

CITATION INFORMATION: Kim J-.D., Choi D-.L., Kim T. Single-Center Experience of Biliary Reconstruction for Multiple Bile Duct in Right Lobe Living Donor Liver Transplantation Am J Transplant. 2017;17 (suppl 3).

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