当前位置： SCI文献检索 > TRANSPLANTATION PROCEEDINGS期刊下所有文献 > Anatomical classification of the peripheral right hepatic duct: early identification of a preventable source of morbidity and mortality in adult live donor liver transplantation.

Anatomical classification of the peripheral right hepatic duct: early identification of a preventable source of morbidity and mortality in adult live donor liver transplantation.

Abstract：

INTRODUCTION:The purpose of this study was to determine the impact of our classification on right graft adult live donor liver transplantation (ALDLT) outcomes. METHODS:Three-dimensional computed tomography (CT) reconstructions were used to classify the hilar and sectorial biliary anatomy of 71 consecutive live liver donors. Four possible clinical types were defined, based on the normal (N) or abnormal (A) features of the corresponding hilar/sectorial ducts: type I, N/N; type II, N/A; type III, A/N; and type IV, A/A. We subsequently performed an analysis of the operative outcomes based on the donor anatomy. RESULTS:Type I was encountered in 47.9% of cases, type II in 29.6%, type III in 19.7%, and type IV in 2.8%. The highest incidence of biliodigestive anastomoses was observed with type III (50%) and type IV (100%) variants. Type I was associated with the highest incidence of single anastomoses (single vs multiple, P = .001) and of single bile duct anastomoses (single vs multiple, P = .004). Type III was associated with more multi-duct reconstructions compared with types I and II (P = .002 and P = .05, respectively). There were no significant differences in early (P = .08) or late (P = .33) biliary complications, or deaths due to a biliary etiology (P = .55) among the 4 types. CONCLUSIONS:Complex biliary anatomy in the right liver graft usually requires biliodigestive anastomoses, which are often associated with complicated procedures. The precise delineation of the intrahepatic biliary anatomy provided by our clinical classification may contribute to better morbidity and mortality rates, especially for grafts at greatest anatomical risk.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Radtke A,Sgourakis G,Sotiropoulos GC,Molmenti EP,Fouzas I,Schroeder T,Saner FH,Schenk A,Beckebaum S,Malagó M,Lang H

doi

10.1016/j.transproceed.2008.08.044

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

3155-7

issue

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(08)01122-6

journal_volume

pub_type

杂志文章

在线工具

Anatomical classification of the peripheral right hepatic duct: early identification of a preventable source of morbidity and mortality in adult live donor liver transplantation.