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1000 Titel
  • Surgical Duct-to-Duct Reconstruction: an Alternative Approach to Late Biliary Anastomotic Stricture After Deceased Donor Liver Transplantation
1000 Autor/in
  1. Mittler, Jens |
  2. Chavin, Kenneth D. |
  3. Heinrich, Stefan |
  4. Kloeckner, Roman |
  5. Zimmermann, Tim |
  6. Lang, Hauke |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-07-29
1000 Erschienen in
1000 Quellenangabe
  • 25(3):708-712
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s11605-020-04735-y |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940287/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Bilio-enteric diversion is the current surgical standard in patients after deceased donor liver transplantation (DDLT) with a biliary anastomotic stricture failing interventional treatment and requiring surgical repair. In contrast to this routine, the aim of this study was to show the feasibility and safety of a duct-to-duct biliary reconstruction.!##!Patients!#!Between 2012 and 2019, we performed a total of 308 DDLT in 292 adult patients. The overall biliary complication rate was 20.5%. Patients with non-anastomotic or combined strictures were excluded from this analysis. Out of 273 patients after a primary duct-to-duct reconstruction, 20 (7.3%) developed late isolated AS. Seven of these patients failed interventional biliary treatment and required a surgical repair.!##!Results!#!Duct-to-duct reconstruction was feasible and successful in all patients. Liver function tests fully normalized and no patient required any form of biliary intervention after surgery. One patient with intraoperative cholangiosepsis was ICU bound for 5 days, and another patient with a subhepatic abscess required percutaneous drainage. There was no perioperative death. The median length of hospital stay was 8 (5-17) days. The median time of follow-up after relaparotomy was 1593 (434-2495) days.!##!Conclusion!#!Duct-to-duct reconstruction is a feasible and safe option in selected patients requiring surgical repair for isolated AS after DDLT. This approach preserves the biliary anatomy and avoids the potential side effects of a bilio-enteric diversion.
1000 Sacherschließung
lokal Biliary complication
lokal Constriction, Pathologic/surgery [MeSH]
lokal Adult [MeSH]
lokal Biliary Tract Surgical Procedures [MeSH]
lokal Humans [MeSH]
lokal Treatment Outcome [MeSH]
lokal Surgical bile duct repair
lokal Retrospective Studies [MeSH]
lokal Constriction, Pathologic/etiology [MeSH]
lokal Postoperative Complications/surgery [MeSH]
lokal Anastomosis, Surgical/adverse effects [MeSH]
lokal Original Article
lokal Biliary reconstruction
lokal Liver Transplantation/adverse effects [MeSH]
lokal Living Donors [MeSH]
lokal Postoperative Complications/etiology [MeSH]
lokal Hepatico-jejunostomy
lokal Bile Ducts/surgery [MeSH]
lokal Bilio-enteric diversion
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0002-2469-6036|https://frl.publisso.de/adhoc/uri/Q2hhdmluLCBLZW5uZXRoIEQu|https://frl.publisso.de/adhoc/uri/SGVpbnJpY2gsIFN0ZWZhbg==|https://frl.publisso.de/adhoc/uri/S2xvZWNrbmVyLCBSb21hbg==|https://frl.publisso.de/adhoc/uri/WmltbWVybWFubiwgVGlt|https://frl.publisso.de/adhoc/uri/TGFuZywgSGF1a2U=
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1000 Erstellt am 2023-11-18T13:18:42.904+0100
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1000 Zuletzt bearbeitet 2024-04-04T10:52:23.939+0200
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