Utility of a routine bench cholangiogram for ex situ split liver procedure
| Autor: | Venumadhav Thumma, Paolo Muiesan, Narendra Battula, John Isaac, Ravindar Anbarasan, Darius F. Mirza, M. Thamara P. R. Perera, Khalid Sharif |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Radiography medicine.medical_treatment Intrahepatic bile ducts 030230 surgery Liver transplantation 03 medical and health sciences Young Adult 0302 clinical medicine medicine Hepatectomy Humans Clinical significance Biliary Tract Retrospective Studies Transplantation Suture ligation business.industry Middle Aged Tissue Donors Liver Transplantation medicine.anatomical_structure Liver Split liver transplantation Drainage 030211 gastroenterology & hepatology Female Radiology business Duct (anatomy) BCH code Cholangiography Follow-Up Studies |
| Zdroj: | Clinical transplantation. 33(7) |
| ISSN: | 1399-0012 |
| Popis: | Background Biliary complications can result in a significant morbidity for split liver graft recipients. Biliary drainage for segment 1 and 4 is highly variable and could be the source of bile leaks. Use of a bench cholangiogram (BCH) can accurately define the segmental biliary system and identify any significant biliary radicles that need retention or repair during bench preparation of split grafts. This study evaluates the clinical relevance of routine BCH in split liver transplantation (SLT). Methods Retrospective review of 100 BCH images performed during ex situ deceased donor SLT between January 2009 and January 2015. The radiographs were reviewed by two surgeons and the biliary anatomy was compared using Huang and Reichert classification. Results 100 BCH images were reviewed. Variant anatomy was frequently identified in the intrahepatic bile duct system, the number and drainage patterns of segment 1&4 duct was diverse. BCH results guided the line of parenchymal transection to obtain a single segment 2&3 duct in 15 cases. A surgical intervention in the form of suture ligation of significant segment 1 or 4 duct at bench preparation was performed in 6 cases. BCH images guided surgical control of post-operative bile leak in 3 patients. Conclusion Bench cholangiogram is a useful tool to guide liver parenchymal transection and potentially reduce the incidence of biliary complications. |
| Databáze: | OpenAIRE |
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