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| Optimizing biliary outcomes in living donor liver transplantation: Evolution towards standardization in a high-volume center |
| Tsan-Shiun Lin, Jeffrey Samuel Co, Chao-Long Chen ∗, Aldwin D. Ong |
Liver Transplantation Center, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao Sung, Kaohsiung 833, Taiwan, China
∗ Corresponding author.
E-mail address: clchen@cgmh.org.tw (C.-L. Chen). |
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Abstract Biliary complications have always been a dreaded cause of morbidity after living donor liver transplantation. While intrinsic variations in both graft and recipient biliary anatomy remain a significant factor to the difficulty of biliary reconstruction, our institution has taken advantage of its high volume of cases to critically review and evaluate modifiable operative risk factors, in particular, our surgical protocols. We present herein, the evolution of our reconstructive biliary technique from conventional methods to our current standard of microsurgical biliary reconstruction for both graft and recipient ducts. Over this period of transition, our center has created a classification system for biliary reconstruction that decreased the biliary complication rates from 40.0% to 10.2%.
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2020, Vol. 19 
