Table 9.14. Indications for choledochojejunostomy

1. Donor-recipient bile duct size discrepancy

2. Diseased recipient bile duct a) Secondary biliary cirrhosis b) Primary sclerosing cholangitis c) Choledocholithiasis d) Biliary atresia

3. Presence of biliary duct malignancy

4. Poor blood supply to recipient bile duct

5. Inability to pass biliary probe through ampulla

Fig. 9.4A and B. A) Piggyback technique. This figure illustrates the preparation for the piggyback cavo-cavo plasty. First, the donor suprahepatic IVC is viewed from the back where a vertical slit is made in the middle of the back wall. This is triangulated to match the triangulated hepatic vein opening on the recipient side. Finally, the liver is viewed after all of the anastomoses have been completed showing an end on view. B) Side view of the piggyback procedure. Showing the triangulated cavo-cavo plasty of the donor suprahepatic IVC and the ligated infrahepatic IVC.

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