This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
In ohotopic liver transplantation, which is the best way to get bile drainage in donor liver: 
Select and explain. 
A. Anastomose donor bile duct with the duodenum of recipient, B. Anastomose donor bile duct with the jejunum of recipient, C. Anastomose donor bile duct with recipient bile duct or Roux-en-Y choledochojejunostomy, D. External drainage for few days followed by choledochojejunostomy
C: Anastomose donor bile duct with recipient bile duct or Roux-en-Y choledochojejunostomy
Answer: C: Anastomose donor bile duct with recipient bile duct or Roux-en-Y choledochojejunostomy 
Explanation: Ans is 'c' i.e. Anastomose donor bile duct with recipient bile duct or Roux-en-Y choledochojejunostomy "Caval, poal vein, hepatic aery, and bile duct anastomoses are performed in succession, the last by end-to-end suturing of the donor and recipient common bile ducts or by choledochojejunostomy to a Roux-en- Y loop if the recipient common bile duct cannot be used for reconstruction (e.g., in sclerosing cholangitis)."- Harrison 17/e p Bile duct anastomosis in ohotopic liver transplant is done by Choledochocholedochostomy or Roux-en-Y choledochojejunostomy Choledochocholedochostomy end to end anastomosis between donor CBD and the recipient CBD used when the recipient bile duct is not diseased preferred method of bile duct anastomoses Roux-en-Y choledochojejunostomy alternative bile duct anastomosis when choledochocholedocostomy is not possible, that is when recipient extrahepatic bile duct is diseased (eg. sclerosing cholangitis), or small or when there is significant recipient donor duct size mismatch.