BILIARY COMPLICATIONS AFTER LIVER TRANSPLANTATION

The aim of our research is to perform a retrospective analysis of all cases involving biliary complications after liver transplantation in two transplant centers of Kazakhstan. In the period from December 2011 and December 2019, 106 adult patients underwent LT at Syzganov's National Scientific Center of Surgery and City Clinical Hospital №7, Almaty, Kazakhstan. Eighty-nine (84%) patients underwent living donor liver transplantation (LDLT) from an adult donor, while 17 (16%) patients underwent deceased donor liver transplantation. The graft types were as follows: whole liver (n=17; 16%), right lobe (n=82; 77.3%), left lobe (n=6; 5.6%), and right posterior section (n=1; 0.9%). Duct-to-duct anastomosis was performed in 102 cases, the types of which were as follows single duct-to-duct anastomosis (n=95; 93.1%), double duct-to-duct anastomosis (n=5; 4.9%), combined-type anastomosis (duct-to-duct anastomosis and roux-en-Y hepaticojejunostomy [n=2; 1.9%]). Roux-en-Y hepaticojejunostomy was performed in 3 cases. A biliary splint was used in 53 (52%) cases; biliary splints were not used in 49 (48%) cases. Preoperative and intraoperative methods of investigating (MRC, IOC) the biliary tracts can reveal the types of biliary tracts and are useful for planning the type of biliary reconstruction. Various types of biliary reconstruction are associated with a high risk of biliary complications after liver transplantation. Biliary splinting in duct-to-duct anastomosis reduces the incidence of biliary complications.