Background : In living donor liver transplantation(LDLT), biliary complication (BC) is most common and intractable complication. There is no optimal method of reconstruction to reduce these complication. The most common biliary reconstruction is duct-to-duct anastomosis (DDA) in LDLT. And placing external biliary drainage (EBD) across the biliary anastomosis is good method to reduce BC. Unlike the general method of maintaining the drainage tube for 3 months to 12 months, our institution tried a short-term placement method of 6 weeks. This study reported the single institutional experience of short-term EBD in LDLT.

Methods : A total of 123 patients underwent LT from January 2013 to November 2022 in The Catholic University of Korea Incheon St. Mary’s hospital. 53 patients who underwent deceased donor liver transplantation and 11 patients who lack of data were excluded. A retrospective cohort study was conducted on total 59 patients who underwent a LDLT with EBD and DDA. EBD was placed across the biliary anastomosis during operation. EBD was naturally drained for the first 1 to 3 weeks and was removed after 6 weeks.

Results : The overall BC was occurred in 22 patients (37.3%). 3 (5.1%) of early biliary fistula, 5 (8.5 %) of early biliary stricture, and 14 (23.7%) of late biliary stricture was occurred. All of BC was resolved by intervention (ERBD, PTBD). There was no re-operation for resolving BC. There was no mortality related to BC. There was no bile leakage after removal of the drainage tube.

Conclusions : A single institutional experience showed the effectiveness and safety of short-term EBD.