Application of choledochojejunostomy in liver transplantation

doi:10.3877/cma.j.issn.1674-0793.2007.03.009

Abstract

Abstract:

Objective

To evaluate the application and rate of complications related to Roux-en-Y choledochojejunostomy in liver transplantation.

Methods

A retrospective analysis was made for 24 cases who received choledochojejunostomy in liver transplantation consecutively in our transplantation center.

Results

421 transplantation procedures were performed from Oct.2004 to Oct.2006， 24 patients chose choledochojejunostomy.18 patients were cured.Biliary complications occurred in 6 patients (25%)， including anastomotic strictures (3 patients)， ascending cholangitis (2 patients) ， anastomotic strictures combined with bile leakage (1 patient). A univariate statistical analysis found that the risk factors for biliary complication were Child-Pugh stage C (P<0.05).4 patients were successfully treated by percutaneous transhepatic balloon dilatation and stenting. 1 patient suffered from extensive biliary necrosis and 1 patient was died of septic shock.

Conclusion

Hepaticojejunostomy is a safe and highly effective biliary reconstruction during orthotopic liver transplantation， especially when the recipients' bile duct is absent or otherwise destroyed，but anastomotic strictures and ascending cholangitis are still common complications. Compromised primary surgery and selective use of external biliary drainage may help to reduce biliary complication associated with hepaticojejunostomy.

Key words: Liver transplantation, Hepaticojejunostomy

Shu-hong YI, Chang-jie CAI, Min-qiang LU, Yang YANG, Chi XU, Hua LI, Hui-min YI, Gen-shu WANG, Gui-hua CHEN. Application of choledochojejunostomy in liver transplantation[J]. Chinese Archives of General Surgery(Electronic Edition), 2007, 01(03): 152-155.

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URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2007.03.009

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2007/V01/I03/152

分组	年龄(岁)	性别(例%)		肝功能分级(child-pugh)			免疫抑制剂
分组	年龄(岁)	男	女	A	B	C	FK506	CsA
无胆道并发症	43.5±13.2	16(88.9%)	2(11.1%)	6(33.3%)	8(44.4%)	4(22.2%)	14(77.8%)	4(22.2%)
有胆道并发症	46.8±11.6	5(83.3%)	1(16.7%)	0(0)	1(16.7%)	5(83.3%)	4(66.7%)	2(33.3%)
分组	手术时间(h)	术前手术史		肺部感染发生率	肝动脉并发症		放置胆道引流管
无胆道并发症	6.3±0.9	13(72.2%)		5(27.8%)	1(5.5%)		7(38.9%)
有胆道并发症	6.5±1.1	3(50%)		2(33.3%)	0(0)		2(33.3%)

分组	年龄(岁)	性别(例%)		肝功能分级(child-pugh)			免疫抑制剂
分组	年龄(岁)	男	女	A	B	C	FK506	CsA
无胆道并发症	43.5±13.2	16(88.9%)	2(11.1%)	6(33.3%)	8(44.4%)	4(22.2%)	14(77.8%)	4(22.2%)
有胆道并发症	46.8±11.6	5(83.3%)	1(16.7%)	0(0)	1(16.7%)	5(83.3%)	4(66.7%)	2(33.3%)
分组	手术时间(h)	术前手术史		肺部感染发生率	肝动脉并发症		放置胆道引流管
无胆道并发症	6.3±0.9	13(72.2%)		5(27.8%)	1(5.5%)		7(38.9%)
有胆道并发症	6.5±1.1	3(50%)		2(33.3%)	0(0)		2(33.3%)

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