{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:31:07Z","timestamp":1785346267942,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2010,7,3]],"date-time":"2010-07-03T00:00:00Z","timestamp":1278115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Purpose<\/jats:title><jats:p>Liver transplantation is an established therapy for children with end\u2010stage chronic liver disease or acute liver failure. However, despite refinements of surgical techniques for liver transplantation, the incidence of biliary tract complications has remained high in recent years. Therefore, we suggest our anastomotic technique with wide\u2010interval interrupted suture to prevent biliary complications in pediatric living\u2010donor liver transplantation (LDLT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010nine LDLTs were performed on 49 pediatric recipients with end\u2010stage liver disease. Biliary reconstruction was performed using a 2.5\u00d7 magnifying surgical loupe, via end bile duct to side Roux\u2010en\u2010Y hepaticojejunostomy (<jats:italic>n<\/jats:italic> = 47) and duct\u2010to\u2010duct choledochocholedochostomy (<jats:italic>n<\/jats:italic> = 2) with an external stent. A stay suture with 6\u20100 absorbable materials was placed at each end of the anastomotic orifice. Two interrupted sutures of the posterior row were performed. After completion of the suture of the posterior row, an external transanastomotic stent tube was inserted into the intrahepatic bile duct and was fixed with posterior row material. Finally, two interrupted sutures of the anterior wall were performed, totaling six stitches. The transanastomotic stent tube emerging out of the blind end of the Roux\u2010en\u2010Y limb was covered with a round ligament and was usually left in place for 1 month after the operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up period was 58.0 months (range 8\u2013135 months). In 33 recipients, the bile duct was used to perform the reconstruction with a single lumen. In 5 cases, there were 2 bile ducts that were formed to enable a single anastomosis. In 10 cases, there were 2 separated ducts and each duct was anastomosed with the recipient jejunum. In one case, there were 3 ducts that were formed to enable two anastomoses. Twenty\u2010two percent of the living\u2010donor grafts required 2 biliary anastomoses. Forty\u2010four patients (89.8%) are alive (ranging from 8 months to 11 years), and 5 patients have died. Two patients had biliary complications, an anastomotic stricture in one (2.0%) and bile leakage in one. There were no complications due to anastomotic tubes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Biliary reconstruction with wide\u2010interval interrupted suture prevents anastomotic strictures and bile leakage in pediatric LDLT.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00534-010-0301-5","type":"journal-article","created":{"date-parts":[[2010,7,2]],"date-time":"2010-07-02T11:11:05Z","timestamp":1278069065000},"page":"26-31","source":"Crossref","is-referenced-by-count":23,"title":["Biliary reconstruction with wide\u2010interval interrupted suture to prevent biliary complications in pediatric living\u2010donor liver transplantation"],"prefix":"10.1002","volume":"18","author":[{"given":"Hisami","family":"Ando","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery Nagoya University Graduate School of Medicine  65 Tsurumai\u2010cho, Showa\u2010ku Nagoya 466\u20108560 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenitiro","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Nagoya University Graduate School of Medicine  65 Tsurumai\u2010cho, Showa\u2010ku Nagoya 466\u20108560 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Nagoya University Graduate School of Medicine  65 Tsurumai\u2010cho, Showa\u2010ku Nagoya 466\u20108560 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahisa","family":"Tainaka","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Nagoya University Graduate School of Medicine  65 Tsurumai\u2010cho, Showa\u2010ku Nagoya 466\u20108560 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