Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 13;102(41):e35396.
doi: 10.1097/MD.0000000000035396.

Short limb in biliary tract reconstruction: A retrospective study of living donor liver transplantation in children with biliary atresia

Yuhong Zhang  1   2 , Zhijun Zhu  1
Affiliations

Short limb in biliary tract reconstruction: A retrospective study of living donor liver transplantation in children with biliary atresia

Yuhong Zhang et al. Medicine (Baltimore). .

Abstract

Roux-en-Y cholangiojejunostomy is a standard procedure for biliary reconstruction in pediatric living donor liver transplantation (LDLT). However, there is uncertainty on whether the adult standard of Roux branch limb is suitable for pediatric LDLT and its impact on postoperative biliary complications (BC). This study aimed to explore the effect of the short Roux limb and standard limb on pediatric LDLT biliary reconstruction. According to the length of the Roux limb, 168 LDLT children were divided into the routine limb group (n = 108) and the short limb group (n = 60). The incidences of postoperative biliary tract complications between the 2 groups were compared retrospectively. The mean Roux limb length in the short limb group was significantly shorter than that in the routine limb group group (P < .01). There were significant differences in age, height, and weight between the 2 groups (P < .01). However, there were no significant differences in graft-to-recipient weight ratio, intraoperative blood loss, cold ischemia time, and operation time between the 2 groups (P > .01). Moreover, postoperative BC, including refluxing cholangitis, were similar between the 2 groups (P = .876). Furthermore, the history of Kasai surgery, the history of postoperative RC of Kasai, and whether or not the Roux limb was reconstructed had no significant effect on the occurrence of postoperative RC. There was no significant difference in postoperative BC between the short limb and the routine limb in children with living donor liver transplantation.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

References

    1. Colledan M, D’Antiga L. Biliary complications after pediatric liver transplantation: the endless heel. Pediatr Transplant. 2014;18:786–7. - PubMed
    1. Laurence JM, Sapisochin G, DeAngelis M, et al. Biliary complications in pediatric liver transplantation: incidence and management over a decade. Liver Transpl. 2015;21:1082–90. - PubMed
    1. Ducrotte P, Peillon C, Guillemot F, et al. Could recurrent cholangitis after Roux-en-Y hepaticojejunostomy be explained by motor intestinal anomalies? A manometric study. Am J Gastroenterol. 1991;86:1255–8. - PubMed
    1. Zhao YW, Huang DH. The Relationship Between Choledochojejunostomy and Post-Operative Cholangitis. Chang Chun: Bai Qiu En Medical University. 1994.
    1. Shirouzu Y, Okajima H, Ogata S, et al. Biliary reconstruction for infantile living donor liver transplantation: Roux-en-Y Hepaticojejunostomy or Duct-to-Duct Choledochocholedochostomy? Liver Transpl. 2008;14:1761–5. - PubMed