Intrahepatic biliary anatomy derived from right graft adult live donor liver transplantation.

Transplant Proc

Department of General and Abdominal Surgery, Johannes Gutenberg University Hospital, Mainz, Germany; Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Essen, Germany.

Published: November 2008

Objective: The successful management of the bile duct in right graft adult live donor liver transplantation requires knowledge of both its central (hilar) and distal (sectorial) anatomy. The purpose of this study was to provide a systematic classification of its branching patterns to enhance clinical decision-making.

Patients And Methods: We analyzed three-dimensional computed tomography (3-D CT) imaging reconstructions of 139 potential live liver donors evaluated at our institution between January 2003 and June 2007.

Results: Fifty-four (n = 54 or 38.8%) donor candidates had a normal (classic) hilar and sectorial right bile duct anatomy (type I). Seventy-eight (n = 78 or 56.1%) cases had either hilar or sectorial branching abnormalities (types II or III). Seven (n = 7 or 5.1%) livers had a mixed type (IV) of a rare and complex central and distal anatomy.

Conclusions: We believe that the classification proposed herein can aid in the better organization and categorization of the variants encountered within the right-sided intrahepatic biliary system.

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http://dx.doi.org/10.1016/j.transproceed.2008.08.048DOI Listing

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