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364605

En bloc high hilar dissection versus conventional hilar dissection in living donor liver transplantation donors: a comparative, single-center study

Article

Last updated: 29 Dec 2024

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Abstract

Background
Living donor liver transplantation (LDLT) has become an accepted treatment option for end-stage liver disease. Biliary complications still remain a major concern and are considered the Achilles’ heel of LDLT, with a morbidity ranging between 20 and 42.1%. The high incidence of biliary complications can be attributed mainly to the affection of the blood supply of bile ducts. The high hilar dissection technique was described aiming at preservation of bile duct vascular supply.
Patients and methods
A total of 66 adult LDLT donors were operated in a single, liver transplant center (Ain Shams University Specialized Hospital) between January 2017 and August 2018. The study cases were divided into two groups: group A with conventional hilar dissection and group B with en bloc high hilar dissection. A comparative study was conducted between the two groups as regards early and late biliary complications.
Results
The 66 LDLT donors were divided into two groups: group A included 33 donors with conventional hilar dissection and group B included 33 donors with en bloc high hilar dissection. The occurrence of postoperative biliary leak was significantly more in the conventional hilar dissection group (18.2%) compared with the en bloc high hilar dissection group (3.0%) (=0.046).
Conclusion
The en bloc high hilar dissection technique may decrease the incidence of biliary complications in LDLT donors as it protects the biliary vascular supply and facilitates the closure of the donor stump.

DOI

10.4103/ejs.ejs_14_20

Keywords

conventional hilar dissection, en bloc high hilar dissection and biliary leak, Living donor liver transplantation

Authors

First Name

Ahmed A.

Last Name

Abdelshafy

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Orcid

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First Name

Kamal M.

Last Name

Elsaid

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Abdelrahman M.

Last Name

Elghandour

MiddleName

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Affiliation

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Email

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Orcid

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First Name

Dalia F.

Last Name

Emam

MiddleName

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Affiliation

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Email

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Orcid

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Volume

39

Article Issue

3

Related Issue

48961

Issue Date

2020-08-01

Receive Date

2020-01-13

Publish Date

2020-08-28

Print ISSN

1110-1121

Online ISSN

1687-7624

Link

https://ejsur.journals.ekb.eg/article_364605.html

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https://ejsur.journals.ekb.eg/service?article_code=364605

Order

364,605

Publication Type

Journal

Publication Title

The Egyptian Journal of Surgery

Publication Link

https://ejsur.journals.ekb.eg/

MainTitle

En bloc high hilar dissection versus conventional hilar dissection in living donor liver transplantation donors: a comparative, single-center study

Details

Type

Article

Created At

21 Dec 2024