Intractable & Rare Diseases Research
Online ISSN : 2186-361X
Print ISSN : 2186-3644
ISSN-L : 2186-3644
Case Reports
Two-staged biliary reconstruction with temporary complete external biliary drainage as a bailout procedure in a pediatric patient after difficult living donor liver retransplantation
Hidekazu YamamotoYasuhiko SugawaraSho IbukiKeita ShimataYasuko NaritaTaizo Hibi
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2019 Volume 8 Issue 3 Pages 214-216

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Abstract

Biliary leakage at the site of the hepaticojejunostomy after liver transplantation is a life- threatening complication. We herein present the case of a 7-year-old girl who underwent complete external biliary drainage during difficult living donor liver retransplantation as a bailout procedure. The patient had undergone duct-to-duct biliary reconstruction in the initial living donor liver transplantation. In the retransplantation, Roux-en-Y (RY) reconstruction was planned but abandoned due to the critical condition in the operation. As an alternative procedure, the patient underwent complete external drainage using a 6Fr drainage tube with cuff. Five months after retransplantation when the nutrition status and physical strength of a patient recovered fully, RY hepaticojejunostomy was successfully performed. This is a case report of two-staged biliary reconstruction with temporary complete external biliary drainage used in pediatric liver retransplantation, which was performed after some months not a few days. It is a safe and feasible alternative when primary anastomosis is deemed to carry a high risk of bile leakage in cases of difficult liver transplantation in critically ill patients.

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© 2019 International Research and Cooperation Association for Bio & Socio-Sciences Advancement
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