The Impact of the Multiple Bile Ducts on Postoperative Biliary Complications In Patients Undergoing Living Donor Liver Transplantation

Background: We aimed to investigate the correlation between bile duct number and biliary complications in patients who underwent donor liver transplantation (LDLT).

Methods: We reviewed all patients who underwent LDLT in our hospital between July 2008 and December 2020. The patients were divided into 2 groups according to the number of bile ducts in the living donor graft (single duct [SD] or multiple ducts [MD]). Collected data included donor and recipient demographics, surgical data including bile duct reconstruction, and perioperative and postoperative outcomes. No prisoners were used in this study, and participants were neither coerced nor paid. The current study complies with the Helsinki Congress and the Declaration of Istanbul.

Results: All 70 patients were classified as SD (n = 48) and MD (n = 22). Complications related to the bile duct occurred in 27 (38.6%) patients and were more common in the MD group (54.5% vs 31.3%; odds ratio, 2.4). The MD patients had a longer operation time (1052 ± 251 vs 910 ± 215 minutes, P = .019) and a higher percentage of hepaticojejunostomy (31.8% vs 8.3%, P = .012). Donor age, graft-recipient weight ratio, cold ischemic time, and transfusion volume did not differ between groups. Twenty-one patients (77.7%) fully recovered from complications related to the bile duct, but 3 patients (4.3%) had liver graft failure.

Conclusion: Bile duct-related complications were common in LDLT patients, despite overall good results. Multiple bile ducts may be a potent risk factor for postoperative biliary complications.