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Canlı donör karaciğer nakillerinde, donör safra yollarının bölünmesi donör hepatektominin en kritik aşamalardan biridir. Bu çalışmada, merkezimizde sağ lobektomi uygulanan canlı donörlerin safra yolu varyasyonlarının belirlenmesi ve bu varyasyonların postoperatif alıcı safra komplikasyonları ile ilişkisi araştırılmıştır. Ocak 2016 ile Ocak 2018 arasında yapılan canlı donör hepatektomi olgularının verileri retrospektif olarak incelendi. Araştırmaya sağ lobektomi uygulanan donörler (229 olgu) ve minimum 2 yıl takip süresi olan alıcıları dahil edildi. Re-trasnplantasyon yapılan ve primer biliyer patoloji nedeniyle karaciğer nakli uygulanan alıcılar çalışma dışı bırakıldı. Huang sınıflamasına göre en sık tespit edilen tip A1 (%45) idi. Donörler, greft safra ağzı tek, çift ve üç adet olanlar şeklinde sırasıyla grup A,B ve C olmak üzere üç gruba ayrılarak postoperatif komplikasyonlar karşılaştırıldı. Group A, B ve C sırasıyla 123 (%53,7) , 94 (%41) ve 12 (%5,2) olgudan oluştu. 36 hastada safra komplikasyonu (darlık, kaçak) tespit edildi (%15,7). Gruplar arasında yapılan karşılaştırmada safra komplikasyonu açısından anlamlı fark tespit edilmedi (p>0.05). Pre-perioperatif safra yolu değerlendirmesinin etkin yapılması ve uygun cerrahi stratejinin belirlenmesi durumunda greft safra ağzı sayısının alıcı safra komplikasyonları açısından kötü prognostik etkisi yoktur.
In live donor liver transfusions, the division of the donor’s gland pathways is one of the most critical stages of the donor’s hepatectomy. In this study, the determination of the variations of the yellow path of the living donors applied right lobectomy in our center and the relationship of these variations with postoperative receiver yellow complications has been studied. The data of the live donor hepatectomy occurring between January 2016 and January 2018 were reviewed retrospectively. The study included donors applied right lobectomy (229 facts) and recipients with a minimum of 2 years of follow-up. Re-transplantation was carried out and primary whey pathology caused by a liver transplant was dismissed. According to the Huang classification, the most frequently detected type was A1 (45 percent). The donors were compared with postoperative complications by dividing them into three groups, group A, B and C, respectively, in the form of one, double and three pieces of the greft yellow mouth. Group A, B and C consisted of 123 (53.7 percent), 94 (41 percent) and 12 (5.2 percent) respectively. In 36 patients, a complication of the yellow was detected (dryness, fluidity) (15.7 percent). In the comparison between groups, no significant difference was found in terms of the complication of the yellow (p>0.05). In case of effective pre-perioperative evaluation of the gland pathway and the establishment of a suitable surgical strategy, the number of gland gland oral does not have a bad prognostic effect in terms of receptor gland complications.
Dividing bile ducts during donor hepatectomy is one of the critical step of the living donor liver transplantation. To determine the biliary anatomy of graft who underwent right lobe donor hepatectomy in our center and to evaluate effect of biliary variations on recipient biliary complications was the main purpose of this study. The data of donors who were performed right donor hepatectomy between January 2016 and January 2018, were analyzed retrospectively. Two hundred twenty-nine patients who were carried out right lobe donor hepatectomy and the recipients of these donors who had at least two years follow-up were included in the study. Recipients who underwent liver transplantation due to primary biliary pathology and re-transplanted recipients were excluded. The most detected biliary type was A1 (45%) according to Huang classification. Donors were divided into three groups in related to number of bile duct orifice as group A, B and C which contains one, two and three bile duct orifices, respectively and postoperative biliary complications were compared between these groups. There were 123 (53,7%), 94 (41%) and 12 (5,2%) patients in Group A, B and C, respectively. Thirty-six recipients (15,7%) experienced biliary complications. There was no statistical difference between groups associated with biliary complications (p>0.05). The number of greft bile orifice has no effect on recipient biliary complications wether, if the pre-perioperative assessment of bile anatomy is investigated effectively and the surgical strategy is decided properly.
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
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