H-Index
34
Scimago Lab
powered by Scopus
JCR
Clarivate
Analytics
call: +1.631.629.4327
Mon-Fri 10 am - 2 pm EST

Logo

MSMbanner
Medical Science Monitor Basic Research

AmJCaseRep
MedSciTechnol

eISSN: 2329-0358

Get your full text copy in PDF

A New Approach to Accomplish Intraoperative Cholangiography in Left Lateral Segmentectomy of Living Liver Donation

Lin Wei, Zhong-tao Zhang, Zhi-jun Zhu, Li-ying Sun, Zhi-gui Zeng, Wei Qu, Liang Zhang, En-hui He, Rui-fang Xu, Guang-peng Zhou

(Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University and National Clinical Research Center for Digestive Diseases, Beijing, China (mainland))

Ann Transplant 2019; 24:155-161

DOI: 10.12659/AOT.915400


BACKGROUND: There are 2 main methods of bile duct division in harvesting left lateral segment of a living donor: 1) by intraoperative cholangiography through cystic duct with cholecystectomy, or 2) by direct vision with preoperative magnetic resonance cholangiopancreatography. Here, we present a new approach to cholangiography by using the bile duct stump of the fourth liver segment (B4 stump) to achieve left lateral segmentectomy in pediatric living donor liver transplantation.
MATERIAL AND METHODS: This was a prospective study of 221 living donors who had undergone intraoperative cholangiography via the B4 stump in the course of left lateral segmentectomy. We collected and analyzed the clinical data, including the success rate of cholangiography by catheterizing the B4 stump; the associated time cost; the classification of the donor liver’s biliary anatomy; the number of bile duct orifices on the graft side; and postoperative complications involving the biliary tract.
RESULTS: We were successful in catheterizing B4 stumps in all 221 patients. The mean time cost of these procedures was 7.21±3.62 minutes. Variations in the confluence of the right and left lobes were found in 58 patients (26.24%). Overall, sludge was detected in 18 cases (8.14%), gallstones were found in 3 patients (1.36%), and a polypoid gallbladder lesion was found in 1 patient (0.45%). There were 11 cases (4.98%) of bile leakage; no biliary strictures were found in the donors.
CONCLUSIONS: Intraoperative cholangiography via the B4 stump is an alternative procedure for living donors who undergoes left lateral segmentectomy.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree