Comparison between Stenting and Stentless Technique in Biliary Anastomosis after Living Donor Liver Transplantation

Background billiary complications is the most common complication after LDLT. Biliary complications include stricture, leakage, cholangitis, biliary stones, hemobilia and ductopenia. Risk factors of complications include advanced donor age multiple anastomoses, long cold and warm ischemia times, hepatic artery thrombosis and duct-to-duct reconstruction. Aim of the Work it is a combined retrospective and prospective analytical study to compare between using stent and stentless technique in biliary anastomosis in living donor liver transplantation. Patients and Methods in this observational study we did comparative study between stented and stentless technique. We compared the main complications; leakage, stricture and cholangitis. Diagnosis of each complications is built up by follow up serum liver profile, and Ultrasonography. We did MRCP to diagnose stricture and follow up drains or aspiration of any collection to confirm leakage. All cases of cholangitis was admitted to our hepatobiliary unit to control the condition and to exclude any concomitant stricture or leakage. Results there is a significant decrease in the previously mentioned postoperative biliary complication using stentless technique by decreasing biliary infection rate and, thus, decreasing stricture and leakage. Managment of complicated case was initially done by hospital admission. ERCP was done for all cases of sticture. Conclusion biliary complications after living donor liver transplant can significantly be reduced by using stentless techinque.