Randomized Controlled Clinical Trial of Stented versus Stentless Biliary Anastomosis in Living Donor Liver Transplantation

Abstract

Background:Living donor liver transplantation (LDLT) is a main management method for end-stage liver diseases (ESLD). Bilious reconstructions of living donor grafts have beenperformed either via Roux-en-Y enteric anastomosis or duct to duct anastomosis.

Aim and objectives:The objectives of this work were to determination of the percentage of bilious complications in theintraductal stent tube(IST) group compared to duct-to-duct biliary anastomosis with no IST within the 1^st6-mths postliver transplantations (LT) and to compering the complicationpercentage connected to the stent tubes and its removalvia endoscope

Subjects and Methods: Randomized controlled trial (double- blinded) with registration at clinical trial, this study had been conducted on 30 patients. carried out at Liver transplant unit at Air Force Specialized Hospital and Nasser Institute Hospital.

Results: The following-up interval was one year for surviving patients in both groups. Biliary complications were developed in nine patients as shown in.Two (13.3%) patients in the non-stented group and 3 (20%) cases in the stented group suffered from biliary leakage with no statistically significant difference between both groups. one (6.7%) patient in the non-stented group suffered from biliary stricture with statistically nonsignificant changeamong both groups. 2-cases (13.3%) in the stented group suffered from biliary stricture with cholangitis.  One (6.7%) patient in the no stented group suffered from leakage with cholangitis nonsignificant changeamong both groups.

Conclusion: Our work suggested that intra-ductal trans-anastomotic biliary stenting in LDLT can result in relatively same incidence of biliary complications to stent-less anastomosis. Long-term observationsmight be required to collect adequate informationabout this treatment method to become more popular.