%0 Case Reports
%T Gastric sleeve as an extra-anatomical roux for biliary reconstruction in a pediatric third liver transplant.
%A Hakeem AR
%A Gee H
%A Attia M
%A Raj Prasad K
%J Pediatr Transplant
%V 28
%N 3
%D 2024 May
%M 38659292
%F 1.551
%R 10.1111/petr.14769
%X <B>BACKGROUND: </B>Sir Roy Calne in 1976 described "Biliary reconstruction is the Achilles heel of liver transplantation," and it remains true. In some patients, such as those with short-gut syndrome and concomitant biliary atresia, neither duct to duct nor Roux biliary reconstruction is feasible.<BR><B>METHODS: </B>We present a case of child's third liver transplant (LT), where an innovative extra-anatomical biliary bypass was created using a sleeve from greater curvature of the stomach.<BR><B>RESULTS: </B>The patient is well nearly 10 years following the LT.<BR><B>CONCLUSIONS: </B>This technique could prove to be an important addition to the armamentarium of a surgeon in difficult retransplants and in patients with short-gut syndrome as it provides a viable option with good long-term outcome.