Liver Failure, Liver Diseases, Liver Cancer, Liver Neoplasms, Liver Dysfunction
Conditions
Keywords
Liver transplantation, Living donor liver transplantation, Biliary anastomosis
Brief summary
Comparison of biliary complications in right lobe living donor liver transplantation patients undergoing biliary reconstructions using microscope versus surgical loupes .
Detailed description
Liver transplantation (LT) is the most effective treatment modality in patients with end-stage liver disease and it is also established as a viable treatment option in the field of oncology. Living donor liver transplantation (LDLT) using the right lobe (RL) is a major achievement despite its technical challenges, which has created a significant increase in graft supply. While a secure bile duct anastomosis is one of the basic principles of a successful liver transplant procedure, biliary reconstruction remains the Achilles' heel of LDLT because of the high incidence of posttransplant biliary complications associated with significant recipient morbidity and mortality. Some of these complications are related to technical difficulties due to multiple small biliary orifices, particularly in right lobe grafts. In our center, we have been using microsurgical reconstruction technique for duct-to-duct biliary anastomosis in such grafts. The routine use of this technique has been shown to significantly decrease biliary complications in single-center retrospective studies. However, prospective controlled studies comparing microsurgical and standard biliary reconstruction techniques are lacking. In this study, our objective is to compare posttransplant complications of the two techniques of biliary reconstruction in RL LDLT. 40 patients will be included in the study. They will be randomly allocated in the equal groups.İn group 1 biliary anastomosis will be performed using surgical loupes and İn group 2 biliary anastomosis will be performed using microscope. The patients will be followed for one year after the transplant to compare biliary complications.
Interventions
OTHERSurgical Loupes
Biliary reconstruction will be performed using surgical loupe
OTHERMicroscope
Biliary reconstruction will be performed using microscope
Sponsors
Istanbul Medipol University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
None (Open Label)
Intervention model description
The patients will be randomly allocated in the equal groups.İn group 1 biliary anastomosis will be performed using surgical loupes and İn group 2 biliary anastomosis will be performed using microscope.
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* 1.Primary Adult Living donor liver transplant 2.Right lobe grafts with a single biliary orifice
Exclusion criteria
* 1.Bile duct diameter \< 3mm 2.Biliary costructions with a hepaticojejunostomy 3.Right lobe grafts with multipl biliary orifice
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Biliary complications after living donor liver transplantation | One year | Incidence of biliary complications after living donor liver transplantation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perioperative mortality | Through study completion, an average of 1 year | Mortality |
| Time to biliary complications | One year | Time to biliary complications |
| Biliary complications | One year | Types of biliary complications |
| Biliary related morbidity | One year | Morbidity |
Countries
Turkey (Türkiye)
Outcome results
None listed