Gastric sleeve as an extra-anatomical roux for biliary reconstruction in a pediatric third liver transplant.

Hakeem, AR.; Gee, H.; Attia, M.; Raj Prasad, K.

Gastric sleeve as an extra-anatomical roux for biliary reconstruction in a pediatric third liver transplant.

All Authors

Hakeem, AR.

Gee, H.

Attia, M.

Raj Prasad, K.

LTHT Author

Hakeem, Abdul Rahman
Gee, Harrison
Attia, Magdy
Prasad, Raj

LTHT Department

Liver Unit
Hepatobiliary Surgery
Liver Transplant
Abdominal Medicine & Surgery

Publication Date

2024

Item Type

Case Reports
Journal Article

Abstract

BACKGROUND: Sir Roy Calne in 1976 described "Biliary reconstruction is the Achilles heel of liver transplantation," and it remains true. In some patients, such as those with short-gut syndrome and concomitant biliary atresia, neither duct to duct nor Roux biliary reconstruction is feasible. METHODS: We present a case of child's third liver transplant (LT), where an innovative extra-anatomical biliary bypass was created using a sleeve from greater curvature of the stomach. RESULTS: The patient is well nearly 10 years following the LT. CONCLUSIONS: This technique could prove to be an important addition to the armamentarium of a surgeon in difficult retransplants and in patients with short-gut syndrome as it provides a viable option with good long-term outcome.