Percutaneous radiological treatment of donor biliary complications after living donor liver transplantation

Purpose: We aimed to evaluate percutaneous radiological treatment modalities and success in biliary complications that occur in donors for living donor liver transplantation (LDLT). Materials and Methods: This retrospective study was performed with permission of Malatya Inonu University Research and Publication Ethics Board decision number 2019/5-23. A total of 1839 LDLTs were performed in Inonu University Turgut Özal Medical Center Liver Transplantation Institute between May 2009 and December 2018. Hepatectomy donors were evaluated retrospectivly. Biliary complications in donors were classified according to Modified Clavien-Dindo classification. In the treatment of biliary complications, US-guided percutaneous drainage, endoscopic biliary drainage (ERCP), percutaneous biliary drainage (PTC/PTBD) and surgical treatment were applied and treated by percutaneous radiologycal treament donors were evaluated. Results: Of the 1839 donors, 121 (6.57%) required invasive treatment (Clavien grade III and IV) complications. Of thesee, 51 patients underwent US-guided percutanous drainage and 30 donors who accepted as minor biliary leakage received no additional teratment. İncluding 17 patients with percutaneous drainage therapy, 83 patients underwent ERCP. 53 of thesee, ERCP was successful. A total of 14 patients, 12 of whom donors and 2 of whom aborted donors underwent PTC/PTBD. 8 of thesee were terated successfully. 2 of thesee 8 patients had also autonomic bile tract and were operated under the guidance of placed percutaneous catheters. In 4 patients, the occlusal segment could not be passed and the guide wire was inserted in the percutaneous catheters intraoperatively by the interventional radiologyst. 2 patients were treated percutaneously afte hepatico-jejunostomy. Conclusion: It is noteworthy that PTC/PTBD completes the USG-guided percutaneous drainage and endoscopic treatment; while eliminating the need for surgery in some patients and guides treatment in patients undergoing surgery. Keywords: donor, biliary complication, percutaneous radiologycal treatment