A case of living-donor liver transplantation using the cystic duct for biliary tract reconstruction

Abstract

We report a case of right-lobe living-donor liver transplantation using the cystic duct for biliary tract reconstruction. The patient was a 49-year-old woman who underwent the transplantation for fulminant hepatitis. The donor was her husband, and his preoperative DIC-CT examination showed that the right posterior segmental bile duct spontaneously merged into the common bile duct and was widely separated from the right anterior segmental bile duct. During the operation, it was impossible to transform the anterior duct and posterior duct into a single orifice because the orifices of the ducts were widely separated. Therefore the posterior duct and the anterior duct were separately anastomosed with the cystic duct and the common hepatic duct. Cholangiography and biliary scintigraphy three months after the transplantation and MRCP three years later showed no leakage or stricture at the anastomotic sites. The case suggested the feasibility of usage of cystic duct for biliary tract reconstruction during living-donor liver transplantation.