INTRODUCTION
Living donor liver transplantation (LDLT) is the method of choice for
expanding the liver donor pool in many countries where the cadaveric
organ supply is insufficient. 1,2 The most important
advantages of LDLT are an easily available liver graft, ability to
perform a planned and elective surgery, and a shorter cold ischemia
time. 1,2 Despite of these advantages, safety of
living liver donors (LLDs) is still a matter of debate. Increase in the
number of studies addressing with morbidity and mortality in LLDs
reduced the interest and a motivation in performing LDLT in the western
world; significantly. Studies in current literature reported an overall
morbidity and mortality following living donor hepatectomy (LDH) as
0-67% and 0.1-1%, respectively. 1-3 Biliary
complications following the LDH procedure are the most common of all the
complications. Management of intraoperative or postoperative biliary
complications vary from a strategy of “wait and see” to a complex and
technically demanding surgical procedure such as hepaticojejunostomy
(HJ). Percutaneous transhepatic biliary tract drainage (PTBD:
external-internal, external), percutaneous perihepatic bilioma drainage
(transhepatic or transperitoneal) and endoscopic retrograde
cholangiopancreatography (ERCP) are among the treatment options for
biliary complications. However, there is a lack of consensus regarding
timing and choice of treatment algorithm and which LLDs should undergo
HJ. This study aims to present our treatment algorithm of biliary
complications in LLDs and our technique for PTBD catheter assisted HJ in
necessary cases.