Comparison of 2 Different Types of Arterial and Biliary Anastomoses While Preserving the Gastroduodenal Artery: A Retrospective Study

Objective

Here we investigated 2 different arterial reconstruction procedures with preservation of the gastroduodenal artery (GDA) in orthotopic liver transplantation (OLT).

Methods

A retrospective cohort study was conducted. The clinicopathological data of 40 pairs of donors and recipients who underwent OLT from May 2018 to August 2023 were analyzed. The GDA of all recipients was preserved during the hepatic arteries reconstruction, which were divided into 2 groups according to different anastomosis locations, namely the end-to-side group (E-S group, n = 17, Branch-patch between the common hepatic and the gastroduodenal artery) and end-to-end group (E-E group, n = 23, between common hepatic and proper hepatic).

Results

Demographics did not differ between both groups (P > .05). The warm ischemia time (WIT) was numerically longer in the E-S group (403.3 ± 103.3 vs 195.2 ± 35.8 s; P < .001), but the cold ischemia time (CIT) was numerically shorter in the E-S group (279.2 ± 74.7 vs 325.2 ± 15.1 min; P = .023). The time of artery reconstruction and duration of surgery was numerically shorter in the E-S group (21.0 ± 3.6 vs 51.0 ± 9.1 min, P < .001; 326.0 ± 103.4 vs 422.7 ± 24.6 min, P = .001). The E-S group had a lower resistance index (RI) (0.5 ± 0.3 vs 0.6 ± 0.1; P = .049).

Conclusion

Both groups showed no differences in artery and biliary complications. GDA preservation meets the anatomical and physiological requirements. E-S is superior to E-E by the time of hepatic artery reconstruction and RI.