The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Outcome of donor biliary complications following living donor liver transplantation

  • Woo, Hyun Young (Department of Internal Medicine and Medical Research Institute, Pusan National University Hospital) ;
  • Lee, In Seok (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Chang, Jae Hyuck (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Youn, Seung Bae (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Bae, Si Hyun (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Choi, Jong Young (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Chun, Ho Jong (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • You, Young Kyoung (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, Dong Goo (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Yoon, Seung Kew (Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • Received : 2017.07.27
  • Accepted : 2017.11.10
  • Published : 2018.07.01
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Abstract

Background/Aims: Biliary complications are the most common donor complication following living donor liver transplantation (LDLT). The aim of this study is to investigate the long-term outcomes of biliary complications in right lobe adult-to-adult LDLT donors, and to evaluate the efficacy of endoscopic treatment of these donors. Methods: The medical charts of right lobe donors who developed biliary complications between June 2000 and January 2008 were retrospectively reviewed. Results: Of 337 right lobe donors, 49 developed biliary complications, including 36 diagnosed with biliary leakage and 13 with biliary stricture. Multivariate analysis showed that biliary leakage was associated with the number of right lobe bile duct orifices. Sixteen donors, five with leakage and 11 with strictures, underwent endoscopic retrograde cholangiography (ERC). ERC was clinically successful in treating eight of the 11 strictures, one by balloon dilatation and seven by endobiliary stenting. Of the remained three, two were treated by rescue percutaneous biliary drainage and one by conservative care. Of the five patients with leakage, four were successfully treated using endobiliary stents and one with conservative care. In overall, total 35 improved with conservative treatment. All inserted stents were successfully retrieved after a median 264 days (range, 142 to 502) and there were no recurrences of stricture or leakages during a median follow-up of 10.6 years (range, 8 to 15.2). Conclusions: All donors with biliary complications were successfully treated non-surgically, with most improving after endoscopic placement of endobiliary stents and none showing recurrence on long term follow-up.

Keywords

Acknowledgement

Supported by : National Research Foundation of Korea (NRF), Pusan National University Hospital

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