Effects of variability i̇n biliary duct anatomy of the donör on biliary complications of the recipients after right lobe living-donor liver transplantation

Effects Of Variability İn Biliary Duct Anatomy of The Donör On Biliary Complications of The Recipients After Right Lobe Living-Donor Liver Transplantation Objective: To evaluate the influence of the anatomy of the right posteriorbile duct (RPBD) of the donor according to the portal vein by using intraoperatif cholangiography and MRCP (magnetic resonance cholangiopancreatography) on biliary complications in the recipients after living-donor liver transplantation (LDLT) using right hemi-liver grafts. Background Data: We hypothesized that biliary complications after anastomosis were increased in cases which the donör has supraportal RPBD because of potential injury to the RPBD and the increase at the number of the bile ducts. The biliary anatomy of the donor is more important in right hemi-liver transplantation because the anatomy of the right hepatic duct is more variable than that of the left hepatic duct. Method: A total of 105 LDLTs 71 (%67.6) male, 34 female (%32.4), mean age 40.89 using right hemi-liver grafts with type I, 2, 3 anatomy in Huang biliary classification, were retrospectively investigated. The patients were newly classified based on the confluence pattern of the RPBD by using intraoperatif cholangiography and MRCP (magnetic resonance cholangiopancreatography). The patients were firstly divided into three groups as infraportal type 1 (IP, n = 32), supraportal type 2 (SP, n = 58) and trifurcation type 3 (TR, n= 15) types. Distance between portal konfluence and RPBD was measured as "mm" . Biliary complications are retrospectively evaluated according to the types and supraportal RPBD or infraportal RPBD. Results:18 patients in type 2, all the patients in type 3 have multiple bile duct. The total biliary complication rate was %38.1. The higher complication rate was in type 2 and 3 (%46). Conclusions: A short RPBD, supraportal RPBD and a long caudal segment of the RPBD and multiple bile duct of the donor were significant risk factors for biliary complications in LDLT. Keywords: Biliary anatomy, complications, liver transplantation