vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2021-3-50-60vtio-1266Research ArticleТРАНСПЛАНТАЦИЯ ОРГАНОВORGAN TRANSPLANTATIONБилиарная реконструкция при трансплантации печени у детей весом до 15 кг; сравнение методов «проток в проток» и гепатикоеюностомии на петле по РуLiver transplantation in pediatric patients under 15 kg; duct-to-duct vs. Roux-en-Y hepaticojejunostomy biliary anastomosesDehghaniS. М.DehghaniS. M.

Shiraz

Seyed Mohsen Dehghani 

Shiraz

dehghanism@yahoo.comAtaollahiM.AtaollahiM.

Shiraz

Maryam Ataollahi 

Shiraz

tahghighatt1@gmail.comSalimiF.SalimiF.

Shiraz

Farideh Salimi 

Shiraz

ifaridesalimi@gmail.comKazemiK.KazemiK.

Shiraz

Kourosh Kazemi 

Shiraz

cyrus349@yahoo.comGholamiS.GholamiS.

Shiraz

Siavash Gholami 

Shiraz

siavashgholami2@yahoo.comShahramianI.ShahramianI.

Zabol

Iraj Shahramian, Full Professor of Pediatric Gastroenterology and Hepatology

Zabol

ir_buper@yahoo.comParooieF.ParooieF.

Zabol

Fateme Parooie 

Zabol

fatemeparooie@gmail.comSalarzaeiM.SalarzaeiM.

Zabol

Morteza Salarzaei 

Zabol

mr.mortezasalar@gmail.comAminisefatА.AminisefatA.

Zabol

Alireza Aminisefat 

Zabol

a.aminisefat@gmail.comShiraz Transplant Research Center, Shiraz University of Medical SciencesИранShiraz Transplant Research Center, Shiraz University of Medical SciencesIslamic Republic of IranPediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical SciencesИранPediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical SciencesIslamic Republic of Iran2021170920212335060Copyright © Dehghani S.М., Ataollahi M., Salimi F., Kazemi K., Gholami S., Shahramian I., Parooie F., Salarzaei M., Aminisefat А., 20212021Dehghani S.М., Ataollahi M., Salimi F., Kazemi K., Gholami S., Shahramian I., Parooie F., Salarzaei M., Aminisefat А.Dehghani S.M., Ataollahi M., Salimi F., Kazemi K., Gholami S., Shahramian I., Parooie F., Salarzaei M., Aminisefat A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1266

Трансплантация печени – эффективный способ лечения острой и хронической печеночной недостаточности и метаболических заболеваний печени, позволяющий обеспечить хорошее качество жизни более чем 80% реципиентов. Мы поставили задачу оценить результаты использования методов «проток в проток» и гепатикоеюностомии на петле по Ру при трансплантации печени детям весом менее 15 кг.

Материалы и методы

Материалы и методы. В это одноцентровое ретроспективное исследование включали детей массой менее 15 кг, которым была проведена трансплантация печени в Центре трансплантации органов больницы при Ширазском университете медицинских наук с 2009-го по 2019 г. За 10 лет пациентам была проведена 181 трансплантация с билиарной реконструкцией методом «проток в проток» (группа 1) и гепатикоеюностомией на петле кишечника, выключенной по Ру (группа 2). Все данные получены из медицинских записей пациентов, протоколов операций и данных послеоперационного наблюдения. Для анализа использовали программное обеспечение SPSS-V21.

Результаты исследования

Результаты исследования. Из всех пациентов 94 больным проведена реконструкция желчевыводящих путей методом «проток в проток» (группа 1), в 87 случаях проводили гепатикоеюностомию на петле по Ру (группа 2). Средний возраст пациентов составил 2,46 ± 1,5 года. Наиболее часто показанием к операции являлась атрезия желчевыводящих путей (32%). Самым частым осложнением после хирургического вмешательства в обеих группах была инфекция. Осложнения со стороны сердечно-легочной системы значительно чаще наблюдались в группе 2 (24,1% против 4,3%) (p < 0,001). Инфекционные осложнения также значительно чаще отмечены в группе 2. Заключение. В нашем исследовании выявлена достаточно высокая частота послеоперационных инфекционных осложнений, которые встречались чаще у пациентов, которым проводили гепатикоеюностомию на петле по Ру. За исключением осложнений со стороны желчевыводящих путей, которые в основном наблюдались в группе «проток в проток», другие осложнения чаще встречались в группе гепатикоеюноанастомоза на петле по Ру.

Back ground

Back ground. Liver transplantation is an effective treatment for acute or chronic liver failure and metabolic liver disease, which is associated with good quality of life in over 80 percent of recipients. We aimed to evaluate outcome of duct-to-duct vs. Roux-en-Y hepaticojejunostomy biliary anastomoses in pediatric liver transplant recipients below 15-kg.

Methods

Methods. In this single-center retrospective study, all children less than 15 kg that have undergone liver transplantation at Nemazee Hospital Organ Transplant Center affiliated with Shiraz University of Medical Sciences from 2009 till 2019, were enrolled. Over a 10-yr period, 181 liver transplants were performed in patients with two techniques including duct-to-duct (Group 1) vs. Roux-en-Y hepaticojejunostomy biliary anastomoses (Group 2). All data was collected from patients’ medical records, operative notes, and post-transplant follow up notes. Data was analyzed by SPSS software V21.

Results

Results. Overall, 94 patients had duct to duct anastomosis (group 1) and 87 cases had Roux-en-Y hepaticojejunostomy (group 2). The mean age of the patients was 2.46 ± 1.5. The most common underlying diseases was biliary atresia (32%). The most prevalent complication after the surgery was infection in both groups. cardiopulmonary problems were significantly higher in group 2 (24.1% vs 4.3%) (p < 0.001). The rate of infection was significantly higher in group 2, as well.

Conclusion

Conclusion. Our study showed a relatively high rate of post-operative infection which was the most among patients who had undergone Roux-en-Y hepaticojejunostomy. Except from biliary complications which were mostly observed in DD group, other complications were more common among Roux-en-Y group.

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The authors declare that there are no conflicts of interest present.