METHOD FOR RESTORATION OF BILE OUTFLOW IN ORTHOTOPIC TRANSPLANTATION OF LIVER USING CYSTIC DUCT

Abstract

Method for restoration of bile outflow in orthotopic transplantation of liver using cystic duct may find application in anatomic version characterised by parallel location of cystic and common liver ducts in donor. After cholecystectomy, at the level of bile ducts donor segment intersection, common reservoir is formed with application of common liver and cystic ducts by dissection or wedge-shaped excision of partition segment between them. Level of bile ducts donor segment intersection is selected so that diameter of common reservoir coincides with diameter of recipient bile duct, with which biliobiliary anastomosis is formed. Biliobiliary anastomosis is formed as «end to end». If there are mucous and muscular layers in composition of partition between liver and cystic ducts, they are dissected. Edges of mucous layer are sutured. If only mucous layer is present in composition of partition, it is dissected without further suturing. Such approach supply possibility to overcome discrepancy of sutured ducts diameters and provision of bile outflow from liver in the most physiological version with «end to end» anastomosis.

Keywords

• liver transplantation
• biliary reconstruction