Initiation of Liver Transplantation in Bangladesh: Report on the First Two Successful Cases

Liver transplantation (LT) is the treatment of choice for patients with end-stage liver disease (ESLD). Chronic liver disease due to many causes is prevalent in a significant percentage of the Bangladeshi population. Until recently, liver transplantation facilities were not available, and ESLD patients were dying without treatment. Liver transplantation is a complex procedure that requires integrated and organized approach by a multidisciplinary team. The initiation of liver transplantation in Bangladesh has faced many difficulties. These difficulties have been encountered and overcome in phases. We have successfully performed the first two living-donor liver transplantations (LDLTs) in Bangladesh. The recipient of the first LDLT was a 42-year man with cryptogenic cirrhosis, and the second one was a male of 35 years, suffering from HBV cirrhosis. Both the recipients and donors are doing well and relishing the prospect of a normal life. These two successful liver transplantations are milestones in the development of liver transplantation services in Bangladesh

Management Strategies of Major Hepatobiliary Cysts - A Retrospective Study of 145 Consecutive Patients

Hepatobiliary cysts consist of a heterogeneous group of diseases that differ in cause, prevalence and manifestations. Some are found incidentally on imaging studies and tend to have a benign course. Symptomatic cysts and those become endanger to life need adequate treatment. We are reporting clinical and pathological features of 145 patients with different types of Hepatobiliary cysts along with their therapeutic approaches and outcomes. Study period was September 1997 to July 2006 (107 months). The most common was simple cyst followed by hydatid and choledochal cysts. Fifty-four (37.25%) cysts were asymptomatic and diagnosed incidentally, 75 (51.72%) had some form of symptoms; like abdominal pain, discomfort and swelling. Complications like obstructive jaundice; portal hypertension, vena caval obstruction, bronchobiliary fistula and peritonitis are noted in remaining 16 (11.03%) symptomatic patients. They were treated by partial pericystectomy with omentoplasty (44.83%), excision of the cyst with Roux-en-Y Hepaticojejunostomy or Cholangiojejunostomy (16.55%), partial pericystectomy with closure of the biliary leakage and omentoplasty (13.8%), closed total cystectomy (5.52%), right or left typical or atypical hepatectomy (14.49%), segmental deroofing and fenestration (4.8%). There were no operative deaths or major postoperative complications. The recurrence was documented in 7 patients (4.83%) in the follow up period. Three patients with hepatobiliary cystadenocarcinoma died during follow-up.  In summary, Clinico-pathological features, therapeutic approaches and outcome of 145 Hepatobiliary cysts after surgery has been discussed in the light of published literatures. DOI: 10.3329/jbcps.v27i1.4238 J Bangladesh Coll Phys Surg 2009; 27: 13-21</jats:p