Intra-operative cholangiography for donor gallbladder-sparing left lateral hepatic lobectomy in pediatric living donor liver transplantation

Objective: To explore the feasibility of intra-operative cholangiography via the division line of the IV segment bile duct in gallbladder-sparing left lateral hepatic lobectomy for pediatric living-donor liver transplantation. Methods: To perform the gallbladder-sparing left lateral hepatic lobectomy in pediatric living-donor liver transplantation, the liver parenchyma was dissected in the right of falciform ligament, the relative thick IV segment bile duct was dissected and cut off, and the real-time cholangiography was performed through intubation via the proximal bile duct division line. From April 2012 to December 2013, 52 cases of donor were implemented left lateral hepatic lobectomy with this method. According to the result of chloangiography, the type of bile duct and bile duct division line were determined to observe the changes of the donor maximum gallbladder emptying rate. Results: 52 cases of donor intraoperative cholangiography images were clear, with no operation complications, and the mean postoperative hospital stay was 7 days. The maximum gallbladder emptying rate of preoperative and postoperative 1, 3, 6 months were respectively 81.3%, 81.6%, 75.9% and 79.2%. Conclusion: By the intraoperative cholangiography through the division line of the IV segment bile duct, we can obtain clear image, which may replace the angiography via the cystic gall duct to perform living-donor gallbladder-sparing left lateral hepatic lobectomy.