الفهرس 
Liver Anatomy
Biliary anatomyOnly 14 pages are availabe for public view
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Abstract
Our study included 40 patients who underwent LDLT between January 2014 to
August 2016 at Paul Brousse Hospital, South Paris University, France. The mean age
of the donors was 40.43±9.12 year and the mean age of the recipient was 49.40±13.02
year. The donors were 30 males (75%) and 10 females (25%) and the recipients were
27 males (67.5%) and 13 females (32.5%). The mean donors’ BMI was
28.66±3.65kg/m2 and the mean recipients’ BMI was 29.17±4.90 kg/m2. The
indications for liver transplantation in this study were HCC in 21 cirrhotic patients
(52.5 %) and ESLD in 19 patients (47.5 %). The etiology of ESLD was due to viral
and alcoholic cirrhosis in 6 cases (15%), PSC in 3 cases (7.5%), autoimmune hepatitis
in 3 cases (7.5%), SBC in 3 cases (7.5%), NASH in 2 cases (5%), Wilson’s disease in
1 case (2.5%) and SSC in 1 case (2.5%). The mean preoperative GRWR was 1.13
±.0.23. While the actual intraoperative GRWR 0.92+ 0.25. Preoperative liver biopsy
of our donors revealed no steatosis in 34 (85%) and accepted steatosis (0-5%) in 6
donors (15%). Preoperative assessment of our donors’ biliary anatomy was done using
MRCP and according to Huang classification, our donors were type A1 in 20 (50%),
type A2 in 10 (25%), type A3 in 8 (20%) and type 4 in 2 (5%) donors.
The recipient operation time ranged from 520 to 800 minutes with a mean of
625.85±54.99 minutes. Twenty three (57.5%) patients received right lobe graft while
17 (42.5%) patients received left lobe graft. The mean arterial ischemia time was
142.90 ± 42.72minutes and the mean portal ischemia time was 82.40 ±41.29 minutes.
Different types of venous outflow and inflow reconstructions were done in attempt to
improve the graft regeneration and reduce the graft congestion. Two different
techniques were used for biliary reconstruction in this study:
o D-D biliary reconstruction in 28 (70%) patients included single D-D
anastomosis in 18 patients (45%) (9 of them were with stent; 3 with
internal stent and 6 with external stent) and double D-D anastomosis in
10 patients (25%).
o RYHJ biliary reconstruction in 12 (30%) patients included single
RYHJ in 10 patients (25%) (3 of them were with stent) and double
RYHJ in 2 patients (5%).