Abstract
Background: Over the past few years the hepatic venous reconstruction
techniques during liver transplantation have evolved to achieve better
outcomes. Apart from Conventional Technique (CT), Piggyback (PB) and Side
to Side cavostomy (SS) techniques are increasingly used. Methods: A
retrospective single centre analysis was done using the data available at the
University Vascular and Transplant Surgical Unit of National Hospital of Sri
Lanka. Data on patients’ demography, type of hepatic venous reconstruction,
type of liver transplantation, complications and follow up details were collected.
Results: 23 patients underwent liver transplantation including 15 for PB, 7 for
SS and 1 for CT groups. There was no difference between PB and SS groups in
terms of gender, age and type of liver transplantation. Complications were
common in PB group (80%) compared to SS group (43%) (P = 0.15). Hepatic
Venous Outflow Obstruction (HVOO), primary non function, biliary sepsis
were the common complications in two groups. No HVOO occurred in SS
group. Overall follow up was 125.1 weeks; 137.3 weeks for PB group and 177.6
weeks for SS groups. Conclusions: Although statistically not significant, higher
complication rates were found in PB group compared to SS group. Occurrence
of HVOO should specially be highlighted.
Keywords: Liver transplantation, Hepatic venous reconstruction, Piggyback technique,
Side to side cavostomy, Hepatic venous outflow obstruction