Duct-to-duct biliary reconstruction in living-related liver transplantation1

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Abstract
Bile duct-to duct reconstruction is now used in living-related liver transplantation for adult patients. However, the feasibility remains controversial. Bile duct-to-duct reconstruction was performed in 25 adult patients. In the total hepatectomy of the patients, the hilar plate was dissected at the second-order branch of the bile ducts. The anastomosis was performed using an interrupted suture with an external stent tube. A C tube was inserted from the stump of the cystic duct and introduced into the duodenum. All of the patients survived the operation. During the observation period ranging from 34 to 345 days, biliary complications were observed in 8% cases. Dilation of the bile ducts and an absence of bile output were recognized in one patient each, and necessitated surgical revision. Our preliminary experience in biliary reconstruction seems to warrant its long-term observation in the postoperative period.