In ohotopic liver transplantation, which is the best way to get bile drainage in donor liver:
Correct Answer: Anastomose donor bile duct with recipient bile duct or Roux-en-Y choledochojejunostomy
Description: Ans is 'c' i.e. Anastomose donor bile duct with recipient bile duct or Roux-en-Y choledochojejunostomy "Caval, poal vein, hepatic aery, and bile duct anastomoses are performed in succession, the last by end-to-end suturing of the donor and recipient common bile ducts or by choledochojejunostomy to a Roux-en- Y loop if the recipient common bile duct cannot be used for reconstruction (e.g., in sclerosing cholangitis)."- Harrison 17/e p Bile duct anastomosis in ohotopic liver transplant is done by Choledochocholedochostomy or Roux-en-Y choledochojejunostomy Choledochocholedochostomy end to end anastomosis between donor CBD and the recipient CBD used when the recipient bile duct is not diseased preferred method of bile duct anastomoses Roux-en-Y choledochojejunostomy alternative bile duct anastomosis when choledochocholedocostomy is not possible, that is when recipient extrahepatic bile duct is diseased (eg. sclerosing cholangitis), or small or when there is significant recipient donor duct size mismatch.
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Surgery
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