Intrahepatic cholangiojejunostomy for complex biliary stenosis after pediatric living‐donor liver transplantation

• DOI: 10.1111/petr.12927
• Publication Date: 2017-05-12T08:32:41Z
• Authors: Fernando A. Alvarez; Rodrigo Sanchez C...; Juan Glinka; Martin de Santibañes; Juan Pekolj; Eduardo de Santib...; Miguel A. Ciardullo
• Keywords: Male; Anastomosis, Surgical; Infant; Cholestasis, Intrahepatic; Liver Transplantation; 3. Good health; Biliary Tract Surgical Procedures; 03 medical and health sciences; Bile Ducts, Intrahepatic; Jejunum; Postoperative Complications; Treatment Outcome; 0302 clinical medicine; Child, Preschool; Living Donors; Humans; Female; Follow-Up Studies; Retrospective Studies

The treatment of biliary stenosis after pediatric LDLT is challenging. We describe an innovative technique peripheral IHCJ for the patients with complex in whom percutaneous failed. During surgery, drainage removed and a flexible metal stylet introduced trough tract. Subsequently, most superficial aspect tree recognized by palpation stylet's round tip liver surface. parenchyma then transected until bile duct reached. A side-to-side anastomosis to previous Roux-en-Y limb performed over silicone stent. Among 328 transplants between 1988 2015, 26 developed stenosis. From nine requiring three who had received left lateral grafts from living-related donors due atresia were successfully treated IHCJ. After mean 45.6 months, all are alive normal morphological function tests. presented was feasible safe surgical option treat selected recipients procedures or rehepaticojejunostomy not possible, allowing complete resolution cholestasis thus avoiding retransplantation.