Roux-en-Y choledochojejunostomy is the method of choice for biliary reconstruction in liver transplantation for primary sclerosing cholangitis

Background. Opinion is divided regarding the optimal method of biliary reconstruction after liver transplantation for primary sclerosing cholangitis (PSC). Methods. We investigated biliary complications and graft and patient survival in all patients who underwent liver transplantation for PSC in the United Kingdom between 1994 and 2003. Results. Anastomotic leak rates were similar, but a significantly higher stricture rate was observed in patients who had a duct-to-duct reconstruction compared with those who underwent a Roux-en-Y anastomosis. Graft and patient survival were also markedly worse in patients with a duct-to-duct anastomosis. Conclusions. Roux-en-Y choledochojejunostomy is the method of choice for biliary reconstruction in liver transplantation for PSC.