{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T03:16:09Z","timestamp":1785208569596,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Biliary reconstruction technique during liver transplant (LT) for primary sclerosing cholangitis (PSC) remains controversial. This study aimed to evaluate the incidence of biliary complications in patients with PSC\u00a0having a duct\u2010to\u2010duct (DD) anastomosis or Roux\u2010en\u2010Y hepaticojejunostomy (HJ).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective medical record review of patients with PSC undergoing LT at a single center between June 1st, 2000 and December 31st, 2022 was performed. Primary and secondary endpoints were the incidence of biliary strictures (anastomotic [BAS] and non\u2010anastomotic strictures [NAS]) and non\u2010stricture complications, respectively. Univariable and multivariable regression analyses were performed to identify associations with BAS formation. Patient survival was assessed using a Kaplan\u2013Meier curve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 105 transplants performed for 101 patients, 54 (51.4%) and 51 (48.5%) received DD and HJ anastomoses. Mean recipient age and follow\u2010up was 47\u00a0\u00b1\u00a013\u00a0years and 98\u00a0\u00b1\u00a069\u00a0months. BAS was more common (48.1% vs. 27.5%, OR 2.45, 95% CI 1.09\u20135.54, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03) and occurred earlier (4.8\u00a0months, IQR 2.3\u201313.1 vs. 41.8\u00a0months, IQR 7.2\u201388.7, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) in the DD than the HJ group. NAS (seen in 36.2% of transplants) had a comparable incidence (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.53) in HJ (38.9%) and DD (33.3%) groups. No difference was seen between cohorts regarding time to NAS, requirement for extended biliary dilatation programs (clinically significant biliary stricture), bile leak, and graft failure. On multivariable analysis, only the anastomotic technique was associated with BAS (DD adjusted OR 3.00, 95% CI 1.19\u20137.56, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In carefully selected patients with PSC, DD anastomosis yielded similar outcomes to HJ anastomosis after liver transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12281","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T01:09:12Z","timestamp":1720055352000},"page":"2253-2261","source":"Crossref","is-referenced-by-count":9,"title":["Untangling biliary reconstruction in liver transplants for primary sclerosing cholangitis"],"prefix":"10.1002","volume":"48","author":[{"given":"S. M.","family":"Alwis","sequence":"first","affiliation":[{"name":"Department of Surgery (Austin Health) The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. A.","family":"Fink","sequence":"additional","affiliation":[{"name":"Department of Surgery (Austin Health) The University of Melbourne  Melbourne Victoria Australia"},{"name":"Victorian Liver Transplant Unit Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Furtado","sequence":"additional","affiliation":[{"name":"Department of Surgery (Austin Health) The University of Melbourne  Melbourne Victoria Australia"},{"name":"Victorian Liver Transplant Unit Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery (Austin Health) The University of Melbourne  Melbourne Victoria Australia"},{"name":"Victorian Liver Transplant Unit Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Starkey","sequence":"additional","affiliation":[{"name":"Victorian Liver Transplant Unit Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Jones","sequence":"additional","affiliation":[{"name":"Victorian Liver Transplant Unit Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0165-1564","authenticated-orcid":false,"given":"M. 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