Biliary complications in liver transplantation

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http://www.springerlink.com/content/kq2m1114786453nx/

Biliary complications in liver transplantation

Journal

Hepatology International

Publisher

Springer New York

ISSN

1936-0533 (Print) 1936-0541 (Online)

Category

Review Article

DOI

10.1007/s12-z

Subject Collection

Medicine

SpringerLink Date

Wednesday, September 03, 2008

See Ching Chan1 and Sheung Tat Fan1

(1)

Department of Surgery, Queen Hospital, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, China

Received: 22 May 2008 Accepted: 16 July 2008 Published online: 3 September 2008

Abstract Biliary complications of living donor liver transplantation remain common. The complications of biliary leakage and stricture result in substantial recipient morbidity. A major focus of liver transplantation research is the prevention and reduction of these complications through identification of the multiple factors that are conducive to them. Such factors include the donor bile duct anatomy and quality, and the techniques of donor hepatectomy, recipient hepatectomy, and ductal reconstruction. A low threshold for re-exploration for possible bile leakage prevents development of uncontrolled sepsis. Return of good graft function can usually be expected after successful early endoscopic treatment. Contingent measures of percutaneous transhepatic dilatation and stenting, and revision hepaticojejunostomy have to be exercised with utmost care to avoid hepatic artery injury which may results in graft loss.

Keywords Biliary anastomosis - Complication - Living donor liver transplantation