{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T15:45:38Z","timestamp":1773071138576,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,6,13]],"date-time":"2021-06-13T00:00:00Z","timestamp":1623542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The technique of \u00ab en bloc\u00bb liver and small bowel transplantation (L\u2010BT) spares a biliary anastomosis, but does not protect against biliary complications. We analyze biliary and duodenal complications (BDC) in our pediatric series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 1994 and 2020, 54 L\u2010BT were performed in 53 children. The procurement technique included in situ vascular dissection and pancreatic reduction to the head until 2009 (group A). Thereafter, the whole pancreas was recovered (group B).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine BDCs occurred in 8\/53 (15%) patients (7 in group A and 1 in group B): leak of the donor's duodenal stump (2), stenosis of the extra\u2010pancreatic bile duct (5), and intra\u2010pancreatic bile duct stenosis (2). Median delay for diagnosis of stricture was 8\u00a0months (4\u2013168). Interventional radiology was successful in one child only, the others required reoperations. Two patients died, of biliary cirrhosis or cholangitis, 15\u2010month and 12\u2010year post\u2010L\u2010BT. One was listed and liver re\u2010transplanted 13\u00a0years post\u2010L\u2010BT. At last follow\u2010up, two patients only had normal liver tests and ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BDC after L\u2010BT can cause severe morbidities. Pancreatic reduction might increase this risk. Early surgical complications or chronic pancreatic rejection might be co\u2010factors. Early diagnosis and treatment are key to the long\u2010term prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14014","type":"journal-article","created":{"date-parts":[[2021,6,13]],"date-time":"2021-06-13T15:50:16Z","timestamp":1623599416000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Biliary and duodenal complications after \u00ab\u00a0en bloc\u00bb liver\u2010small bowel transplantation in children. A single center cohort study"],"prefix":"10.1111","volume":"25","author":[{"given":"Erik","family":"Hervieux","sequence":"first","affiliation":[{"name":"Pediatric Surgery H\u00f4pital Universitaire Necker\u2010Enfants Malades APHP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5791-5402","authenticated-orcid":false,"given":"Carmen","family":"Capito","sequence":"additional","affiliation":[{"name":"Pediatric Surgery H\u00f4pital Universitaire Necker\u2010Enfants Malades APHP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phanie","family":"Franchi\u2010Abella","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Centre hospitalier Universitaire de Bic\u00eatre APHP Le Kremlin\u2010Bic\u00eatre France"},{"name":"Universit\u00e9 Paris Sud Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dani\u00e8le","family":"Pariente","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Centre hospitalier Universitaire de Bic\u00eatre APHP Le Kremlin\u2010Bic\u00eatre France"},{"name":"Universit\u00e9 Paris Sud Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9cile","family":"Lozach","sequence":"additional","affiliation":[{"name":"Pediatric Radiology H\u00f4pital Universitaire Necker\u2010Enfants Malades APHP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9rique","family":"Sauvat","sequence":"additional","affiliation":[{"name":"Pediatric Surgery H\u00f4pital Universitaire Necker\u2010Enfants Malades APHP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Lacaille","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology\u2010Hepatoloy\u2010Nutrition H\u00f4pital Universitaire Necker\u2010Enfants Malades APHP Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4418-8706","authenticated-orcid":false,"given":"Christophe","family":"Chardot","sequence":"additional","affiliation":[{"name":"Pediatric Surgery H\u00f4pital Universitaire Necker\u2010Enfants Malades APHP Paris France"},{"name":"Universit\u00e9 Paris Descartes Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,13]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"860","article-title":"En bloc transplantation of liver, stomach, pancreas and small intestine in an infant. 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