【Objective】 Biliary anastomotic strictures occur in 10-30% of liver transplant recipients, and such a complication affects not only the quality of life of the patient, but also the outcome. Biliary stenting may reduce the incidence of biliary stricture after duct-to-duct biliary anastomosis. We investigated the effectiveness of anchoring the biliary tube to the peritoneum for prevention of biliary stricture in living-donor liver transplantation.
【Method】 We analyzed 19 patients who underwent duct-to-duct biliary reconstruction in living-donor liver transplantation from February 2007 to October 2017 We did not anchor the biliary stent to the peritoneum until 2015, and tube dislodgement occurred frequently. Therefore, we started to anchor the stent to the peritoneum. We compared the rate of tube dislodgement, and biliary anastomotic strictures between the two groups.
【Result】 When the stent was not anchored to the peritoneum, 8 of 15 cases developed dislodgement of the biliary stent; biliary anastomotic strictures requiring endoscopic treatment occurred in 4 of the 8 cases. After the stent was anchored to the peritoneum, tube dislodgement did not occur in the following 4 cases.
【Conclusion】 Anchoring of the biliary catheter to the peritoneum seems important to avoid such a complication after living-donor liver transplantation.