{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T15:01:55Z","timestamp":1773327715768,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T00:00:00Z","timestamp":1611014400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T00:00:00Z","timestamp":1611014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>One of the major issues related to the living donor liver transplantation recipient outcome is still the high rate of biliary complication, especially when multiple biliary ducts are present and multiple anastomoses have to be performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation and conclusion<\/jats:title>\n                    <jats:p>We report a case of adult-to-adult right lobe living donor liver transplantation performed for a recipient affected by alcohol-related cirrhosis with MELD score of 17. End-stage liver disease was complicated by refractory ascites, portal hypertension, small esophageal varices and portal gastropathy, hypersplenism, and abundant right pleural effusion. Here in the attached video we described the adult-to-adult LDLT procedures, where a right lobe with two biliary ducts draining respectively the right anterior and the right posterior segments has been transplanted. LDLT required a biliary reconstruction using the native cystic and common bile ducts stented trans-papillary with two 5- French 6\u00a0cm long soft silastic catheter. None major complications were detected during post-operative clinical courses. Actually, the donor and the recipient are alive and well. The technique we describe in the video, allow to keep the biliary anastomoses protected and patent without having the risk of creating cholestasis and the need of invasive additional procedure. No living donor right lobe transplantation should be refused because of the presence of multiple biliary ducts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-020-01045-7","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T08:02:56Z","timestamp":1611043376000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Case report: Trans-papillary free stenting of the cystic duct and of the common bile duct in a double biliary ducts anastomoses of a right lobe living donor transplantation"],"prefix":"10.1186","volume":"21","author":[{"given":"Salvatore","family":"Gruttadauria","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Tropea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duilio","family":"Pagano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Calamia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calogero","family":"Ricotta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasquale","family":"Bonsignore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Li Petri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Cintorino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"di Francesco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,1,19]]},"reference":[{"issue":"36","key":"1045_CR1","doi-asserted-by":"publisher","first-page":"4556","DOI":"10.3748\/wjg.15.4556","volume":"15","author":"S Gruttadauria","year":"2009","unstructured":"Gruttadauria S, di Francesco F, Vizzini GB, Luca A, Spada M, Cintorino D, Petri SL, Pietrosi G, Pagano D, Gridelli B. Early graft dysfunction following adult-to-adult living-related liver transplantation: predictive factors and outcomes. World J Gastroenterol. 2009;15(36):4556\u201360. https:\/\/doi.org\/10.3748\/wjg.15.4556.","journal-title":"World J Gastroenterol"},{"issue":"5","key":"1045_CR2","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1097\/MOT.0000000000000693","volume":"24","author":"P Bhangui","year":"2019","unstructured":"Bhangui P, Saha S. The high-end range of biliary reconstruction in living donor liver transplant. Curr Opin Organ Transplant. 2019;24(5):623\u201330. https:\/\/doi.org\/10.1097\/MOT.0000000000000693.","journal-title":"Curr Opin Organ Transplant"},{"issue":"3","key":"1045_CR3","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1111\/ans.13827","volume":"87","author":"KS Chok","year":"2017","unstructured":"Chok KS, Lo CM. Systematic review and meta-analysis of studies of biliary reconstruction in adult living donor liver transplantation. ANZ J Surg. 2017;87(3):121\u20135. https:\/\/doi.org\/10.1111\/ans.13827.","journal-title":"ANZ J Surg"},{"issue":"4","key":"1045_CR4","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.hbpd.2020.06.012","volume":"19","author":"TS Lin","year":"2020","unstructured":"Lin TS, Co JS, Chen CL, Ong AD. Optimizing biliary outcomes in living donor liver transplantation: evolution towards standardization in a high-volume center. Hepatobiliary Pancreat Dis Int. 2020;19(4):324\u20137. https:\/\/doi.org\/10.1016\/j.hbpd.2020.06.012.","journal-title":"Hepatobiliary Pancreat Dis Int"},{"issue":"2","key":"1045_CR5","first-page":"73","volume":"1","author":"S Gruttadauria","year":"2003","unstructured":"Gruttadauria S, Doria C, Cintorino D, Singhal D, Verzaro R, Foglieni CS, Marino IR, Fung JJ. Outcomes in 139 cases of biliary tract reconstructions from a transplant surgery center. Exp Clin Transplant. 2003;1(2):73\u20138.","journal-title":"Exp Clin Transplant"},{"issue":"7","key":"1045_CR6","doi-asserted-by":"publisher","first-page":"2473","DOI":"10.1016\/j.transproceed.2019.01.160","volume":"51","author":"T Arikan","year":"2019","unstructured":"Arikan T, Emek E, Bozkurt B, Mammadov E, Ceyhan O, Sahin T, Dibekoglu C, Serin A, Aydin U, Tokat Y. Does multiple bile duct anastomosis in living donor liver transplantation affect the postoperative biliary complications? Transplant Proc. 2019;51(7):2473\u20137. https:\/\/doi.org\/10.1016\/j.transproceed.2019.01.160.","journal-title":"Transplant Proc"},{"issue":"8","key":"1045_CR7","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1002\/lt.25472","volume":"25","author":"MS You","year":"2019","unstructured":"You MS, Paik WH, Choi YH, Shin BS, Lee SH, Ryu JK, Kim YT, Suh KS, Lee KW, Yi NJ, Hong SK. Optimal biliary drainage for patients with biliary anastomotic strictures after right lobe living donor liver transplantation. Liver Transpl. 2019;25(8):1209\u201319. https:\/\/doi.org\/10.1002\/lt.25472.","journal-title":"Liver Transpl"},{"issue":"10","key":"1045_CR8","doi-asserted-by":"publisher","first-page":"1954","DOI":"10.1111\/liv.14219","volume":"39","author":"T Sato","year":"2019","unstructured":"Sato T, Kogure H, Nakai Y, Hamada T, Takahara N, Mizuno S, Kawaguchi Y, Akamatsu N, Kaneko J, Hasegawa K, Tada M, Tsujino T, Isayama H, Koike K. Long-term outcomes of endoscopic treatment for duct-to-duct anastomotic strictures after living donor liver transplantation. Liver Int. 2019;39(10):1954\u201363. https:\/\/doi.org\/10.1111\/liv.14219.","journal-title":"Liver Int"},{"issue":"4","key":"1045_CR9","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1016\/j.jamcollsurg.2004.05.278","volume":"199","author":"KS Suh","year":"2004","unstructured":"Suh KS, Choi SH, Yi NJ, Kwon CH, Lee KU. Biliary reconstruction using the cystic duct in right lobe living donor liver transplantation. J Am Coll Surg. 2004;199(4):661\u20134. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2004.05.278.","journal-title":"J Am Coll Surg"},{"issue":"11","key":"1045_CR10","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1002\/lt.20496","volume":"11","author":"K Asonuma","year":"2005","unstructured":"Asonuma K, Okajima H, Ueno M, Takeichi T, Zeledon Ramirez ME, Inomata Y. Feasibility of using the cystic duct for biliary reconstruction in right-lobe living donor liver transplantation. Liver Transpl. 2005;11(11):1431\u20134. https:\/\/doi.org\/10.1002\/lt.20496.","journal-title":"Liver Transpl"},{"key":"1045_CR11","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-020-06522-w","author":"S Gruttadauria","year":"2020","unstructured":"Gruttadauria S, Pagano D, di Francesco F, Foglio A, Camm\u00e0 C, Di Marco V, Petridis I, Cintorino D. Adult to adult living donor liver transplantation in recipients with Low MELD: a strategy intended to overcome donor shortage. Dig Dis Sci. 2020. https:\/\/doi.org\/10.1007\/s10620-020-06522-w.","journal-title":"Dig Dis Sci"},{"key":"1045_CR12","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.ijsu.2020.04.069","volume":"82S","author":"DH Jung","year":"2020","unstructured":"Jung DH, Ikegami T, Balci D, Bhangui P. Biliary reconstruction and complications in living donor liver transplantation. Int J Surg. 2020;82S:138\u201344. https:\/\/doi.org\/10.1016\/j.ijsu.2020.04.069.","journal-title":"Int J Surg"},{"key":"1045_CR13","doi-asserted-by":"publisher","first-page":"381","DOI":"10.12659\/AOT.894082","volume":"20","author":"S Gruttadauria","year":"2015","unstructured":"Gruttadauria S, Pagano D, Liotta R, Tropea A, Tuzzolino F, Marrone G, Mamone G, Marsh JW, Miraglia R, Luca A, Vizzini G, Gridelli BG. Liver volume restoration and hepatic microarchitecture in small-for-size syndrome. Ann Transplant. 2015;20:381\u20139. https:\/\/doi.org\/10.12659\/AOT.894082.","journal-title":"Ann Transplant"},{"issue":"11","key":"1045_CR14","doi-asserted-by":"publisher","first-page":"1512","DOI":"10.1002\/lt.25197","volume":"24","author":"D Kollmann","year":"2018","unstructured":"Kollmann D, Goldaracena N, Sapisochin G, Linares I, Selzner N, Hansen BE, Bhat M, Cattral MS, Greig PD, Lilly L, McGilvray ID, Ghanekar A, Grant DR, Selzner M. Living donor liver transplantation using selected grafts with 2 bile ducts compared with 1 bile duct does not impact patient outcome. Liver Transpl. 2018;24(11):1512\u201322. https:\/\/doi.org\/10.1002\/lt.25197.","journal-title":"Liver Transpl"},{"issue":"7","key":"1045_CR15","doi-asserted-by":"publisher","first-page":"2159","DOI":"10.1016\/j.transproceed.2014.11.069","volume":"47","author":"D Pagano","year":"2015","unstructured":"Pagano D, Cintorino D, Li Petri S, Paci M, Tropea A, Ricotta C, Bonsignore P, Saffioti MC, Spada M, Miraglia R, Gridelli BG, Gruttadauria S. Intra-operative contrast cholangiography in living donor liver transplantation: the ISMETT experience. Transplant Proc. 2015;47(7):2159\u201360. https:\/\/doi.org\/10.1016\/j.transproceed.2014.11.069.","journal-title":"Transplant Proc"},{"key":"1045_CR16","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/1320830","author":"W Tang","year":"2020","unstructured":"Tang W, Qiu JG, Cai Y, Cheng L, Du CY. increased surgical complications but improved overall survival with adult living donor compared to deceased donor liver transplantation: a systematic review and meta-analysis. Biomed Res Int. 2020. https:\/\/doi.org\/10.1155\/2020\/1320830.","journal-title":"Biomed Res Int."},{"issue":"5","key":"1045_CR17","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1001\/jamasurg.2018.5538","volume":"154","author":"SD Colquhoun","year":"2019","unstructured":"Colquhoun SD. The realities of liver transplantation and biliary anastomosis-heroes, heroics, heels, and healing. JAMA Surg. 2019;154(5):440. https:\/\/doi.org\/10.1001\/jamasurg.2018.5538.","journal-title":"JAMA Surg"},{"issue":"5","key":"1045_CR18","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1001\/jamasurg.2018.5527","volume":"154","author":"FM Kaldas","year":"2019","unstructured":"Kaldas FM, Korayem IM, Russell TA, Agopian VG, Aziz A, DiNorcia J, Farmer DG, Yersiz H, Hiatt JR, Busuttil RW. Assessment of anastomotic biliary complications in adult patients undergoing high-acuity liver transplant. JAMA Surg. 2019;154(5):431\u20139. https:\/\/doi.org\/10.1001\/jamasurg.2018.5527.","journal-title":"JAMA Surg"},{"key":"1045_CR19","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25862","author":"V Pamecha","year":"2020","unstructured":"Pamecha V, Sasturkar SV, Sinha PK, Mohapatra N, Patil N. Biliary reconstruction in adult living donor liver transplantation: the all-knots-outside technique. Liver Transpl. 2020. https:\/\/doi.org\/10.1002\/lt.25862.","journal-title":"Liver Transpl"},{"issue":"1","key":"1045_CR20","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1001\/archsurg.137.1.60","volume":"137","author":"MA Mercado","year":"2002","unstructured":"Mercado MA, Chan C, Orozco H, Cano-Guti\u00e9rrez G, Chaparro JM, Galindo E, Vilatob\u00e1 M, Samaniego-Arvizu G. To stent or not to stent bilioenteric anastomosis after iatrogenic injury: a dilemma not answered? Arch Surg. 2002;137(1):60\u20133. https:\/\/doi.org\/10.1001\/archsurg.137.1.60.","journal-title":"Arch Surg"},{"issue":"5","key":"1045_CR21","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1097\/00000658-197605000-00005","volume":"183","author":"JL Cameron","year":"1976","unstructured":"Cameron JL, Skinner DB, Zuidema GD. Long term transhepatic intubation for hilar hepatic duct strictures. Ann Surg. 1976;183(5):488\u201395. https:\/\/doi.org\/10.1097\/00000658-197605000-00005.","journal-title":"Ann Surg"},{"issue":"4","key":"1045_CR22","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1097\/00000658-197810000-00012","volume":"188","author":"JL Cameron","year":"1978","unstructured":"Cameron JL, Gayler BW, Zuidema GD. The use of silastic transhepatic stents in benign and malignant biliary strictures. Ann Surg. 1978;188(4):552\u201361. https:\/\/doi.org\/10.1097\/00000658-197810000-00012.","journal-title":"Ann Surg"},{"issue":"7","key":"1045_CR23","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1001\/archsurg.134.7.769","volume":"134","author":"WR Jarnagin","year":"1999","unstructured":"Jarnagin WR, Blumgart LH. Operative repair of bile duct injuries involving the hepatic duct confluence. Arch Surg. 1999;134(7):769\u201375. https:\/\/doi.org\/10.1001\/archsurg.134.7.769.","journal-title":"Arch Surg"},{"issue":"3","key":"1045_CR24","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1177\/000313480507100313","volume":"71","author":"S Gruttadauria","year":"2005","unstructured":"Gruttadauria S, Vasta F, Minervini MI, Piazza T, Arcadipane A, Marcos A, Gridelli B. Significance of the effective remnant liver volume in major hepatectomies. Am Surg. 2005;71(3):235\u201340.","journal-title":"Am Surg"},{"issue":"6","key":"1045_CR25","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1007\/s00270-010-9848-4","volume":"33","author":"L Maruzzelli","year":"2010","unstructured":"Maruzzelli L, Miraglia R, Caruso S, Milazzo M, Mamone G, Gruttadauria S, Spada M, Luca A, Gridelli B. Percutaneous endovascular treatment of hepatic artery stenosis in adult and pediatric patients after liver transplantation. Cardiovasc Intervent Radiol. 2010;33(6):1111\u20139. https:\/\/doi.org\/10.1007\/s00270-010-9848-4.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"13","key":"1045_CR26","doi-asserted-by":"publisher","first-page":"1438","DOI":"10.3748\/wjg.v18.i13.1438","volume":"18","author":"G Marrone","year":"2012","unstructured":"Marrone G, Crino\u2019 F, Caruso S, Mamone G, Carollo V, Milazzo M, Gruttadauria S, Luca A, Gridelli B. Multidisciplinary imaging of liver hydatidosis. World J Gastroenterol. 2012;18(13):1438\u201347. https:\/\/doi.org\/10.3748\/wjg.v18.i13.1438.","journal-title":"World J Gastroenterol"},{"issue":"2","key":"1045_CR27","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1002\/jso.21796","volume":"103","author":"S Gruttadauria","year":"2011","unstructured":"Gruttadauria S, Saint Georges Chaumet M, Pagano D, Marsh JW, Bartoccelli C, Cintorino D, Arcadipane A, Vizzini G, Spada M, Gridelli B. Impact of blood transfusion on early outcome of liver resection for colorectal hepatic metastases. J Surg Oncol. 2011;103(2):140\u20137. https:\/\/doi.org\/10.1002\/jso.21796.","journal-title":"J Surg Oncol."},{"issue":"1","key":"1045_CR28","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1111\/j.1600-6143.2009.02874.x","volume":"10","author":"S Gruttadauria","year":"2010","unstructured":"Gruttadauria S, Pagano D, Petridis I, Vizzini G, Volpes R, Grossi PA, Gridelli B. Hepatitis C virus infection in a living-related liver donor. Am J Transplant. 2010;10(1):191. https:\/\/doi.org\/10.1111\/j.1600-6143.2009.02874.x.","journal-title":"Am J Transplant"},{"issue":"10","key":"1045_CR29","doi-asserted-by":"publisher","first-page":"3312","DOI":"10.1016\/j.transproceed.2016.09.039","volume":"48","author":"L Janousek","year":"2016","unstructured":"Janousek L, Maly S, Oliverius M, Kocik M, Kucera M, Fronek J. Bile duct anastomosis supplied with biodegradable stent in liver transplantation: the initial experience. Transplant Proc. 2016;48(10):3312\u20136. https:\/\/doi.org\/10.1016\/j.transproceed.2016.09.039.","journal-title":"Transplant Proc"},{"key":"1045_CR30","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.actbio.2020.01.043","volume":"106","author":"E Girard","year":"2020","unstructured":"Girard E, Chagnon G, Broisat A, Dejean S, Soubies A, Gil H, Sharkawi T, Boucher F, Roth GS, Trilling B, Nottelet B. From in vitro evaluation to human postmortem pre-validation of a radiopaque and resorbable internal biliary stent for liver transplantation applications. Acta Biomater. 2020;106:70\u201381. https:\/\/doi.org\/10.1016\/j.actbio.2020.01.043.","journal-title":"Acta Biomater"},{"key":"1045_CR31","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.b.34709","author":"E Girard","year":"2020","unstructured":"Girard E, Chagnon G, Moreau-Gaudry A, Letoublon C, Favier D, Dejean S, Trilling B, Nottelet B. Evaluation of a biodegradable PLA-PEG-PLA internal biliary stent for liver transplantation: in vitro degradation and mechanical properties. J Biomed Mater Res B Appl Biomater. 2020. https:\/\/doi.org\/10.1002\/jbm.b.34709.","journal-title":"J Biomed Mater Res B Appl Biomater"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-020-01045-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12893-020-01045-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-020-01045-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T08:04:41Z","timestamp":1611043481000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcsurg.biomedcentral.com\/articles\/10.1186\/s12893-020-01045-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,19]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1045"],"URL":"https:\/\/doi.org\/10.1186\/s12893-020-01045-7","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-107050\/v1","asserted-by":"object"}]},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,19]]},"assertion":[{"value":"12 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 December 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The research has been performed in accordance with the Declaration of Helsinki. The name of the ethics committee that approved the study is sectional Ethical Committee IRCCS ISMETT, and the committee\u2019s reference number is: IRRB\/42\/16. Informed consents were obtained from the patients to use them medical records for research and publication, and attached as Related Files.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent was obtained from the patient and institution.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication."}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"44"}}