Background : Three primary techniques for bile duct reconstruction in orthotopic liver transplantation include duct to duct (DTD), choledochojejunostomy (CDJ) and choledochoduodenostomy (CDD).The most frequently performed procedure is DTD,as it follows the same anatomical route and serves the same physiological function.The least common option is CDD, which is a simple procedure, faster technique and easier endoscopic access.There is limited information available regarding the outcome of CDD post-liver transplant, particularly in comparison to DTD.Thus,we provided our initial experience comparing CDD and DTD outcomes.

Methods : All 65 patients who underwent liver transplant between January 2021 and May 2023 were included in this study in a consecutive manner.The biliary reconstruction techniques were chosen based on the timing of the operation.DTD was selected from January 2021 to October 2022, followed by the selection of CDD from November 2022 to May 2023. All data were collected and analyzed.

Results : There were no discernible differences in clinicopathological parameters between the two groups. The median cold ischemic time was similar between the two groups (p=0.08).The operative time in the DTD group was significantly longer (368 min) compared to the CDD group (274 min)(p=0.027). Biliary complication was 24.51%(DTD 28.6% vs CDD 4.55% p=0.023).After thoroughly evaluating all relevant factors through multivariate analysis, it was found that the observed difference did not reach statistical significance.

Conclusions : From our data, biliary complications associated with CDD is comparable to DTD.It is evident that CDD may offer a more secure approach to biliary reconstruction in liver transplantation.However, a larger population is necessary to draw further conclusions.