AI Article Synopsis
- The study focuses on comparing two techniques for hepatic artery anastomosis (HAA) in pediatric living donor liver transplantation (LDLT) — one using microsurgery and interrupted sutures, and the other using continuous sutures with lower magnification.
- The research showed that a total of 82 LDLTs were performed, revealing no significant differences in complications except for a reduced arterial ischemia time when using the simpler technique.
- The conclusion highlighted that the simpler technique is effective, with lower complication rates and a streamlined approach that makes the procedure less time-consuming.
Article Abstract
Background/aim: Hepatic artery anastomosis (HAA) is the most important aspect of living donor liver transplantation (LDLT), and it is currently performed by a specialized microsurgeon using micro surgical techniques, with interrupted sutures and the aid of an operative microscope. To simplify the procedure, we studied a new, simpler technique performed by pediatric transplant surgeons with continuous sutures and the same 3.5× magnification loupe used during other transplant procedures. The aim of this study was to compare these two hepatic artery reconstruction techniques in two pediatric LDLT series.
Methods: This study was initiated in January 2010 and finished in June 2013. In the first period, the arterial reconstruction was performed with an operating microscope and the classical technique of 9-0 separate sutures. In the second period, the arterial reconstruction was performed using a simpler technique, with surgical loupe and continuous 8-0 Prolene sutures. The incidences and outcomes of complications within the two periods were analyzed and compared.
Results: A total of 82 LDLTs were performed, 38 in the first period and 44 in the second period. There were no differences between the periods, except for the arterial ischemia time, which was lower in the second period.
Conclusion: Hepatic artery anastomosis can be safely performed with low complication rates by a pediatric transplant surgeon using continuous sutures with a 3.5× magnifying loupe. This technique is simpler, less time consuming and simplifies the complex pediatric LDLT procedure.
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| http://dx.doi.org/10.1016/j.jpedsurg.2014.02.084 | DOI Listing |
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