Having performed over 2200 living donor liver transplantations (LDLTs), we read with interest the article by Vij et al. (1) Essentially, they have modified the hilar plate and Glissonian sheath approach we previously described, (2) by using corner-sparing sutures with mucosal eversion. They ascribe their low rate of biliary complications to the latter 2 steps. We wish to share our anatomic and practical reservations with their concept.Although mucosal eversion of the recipient duct is usually possible, it is less feasible in the donor hepatic ducts (HDs) which are often small and thin-walled.The more intriguing question is of the cornersparing sutures. The duct is supplied by the peribiliary plexus (2,3) between the hepatic duct wall and the hilar plate layers fed by pancreaticoduodenal, gastroduodenal, hepatic, and cystic arteries. The 3 and 9 o'clock arteries are in the wall of the extrahepatic bile duct. However, these arteries do not continue cranially into the right and left HDs. Vellar (4) showed that the 9 o'clock artery joins the right hepatic artery or one of its branches proximal to the right HD in most cases, whereas the 3 o'clock and the transverse hilar arteries terminate in the peribiliary plexus of the left/both HDs. Besides, the orientation and number of HDs in the graft are variable in more than half the cases, making 3 and 9 o'clock positions irrelevant.On the recipient side, in our last 445 LDLTs with at least 1-year follow-up, right and/or left HDs were used for anastomoses in 21%, cystic ducts in 6%, and common hepatic duct (CHD) or Roux loop in the rest. Even when the CHD is used, the bleeding 3 and 9 o'clock arteries either need suture ligation or get plugged with a clot. Hence, whether or not a suture is placed at the 3/9 o'clock positions, the marginal arteries are blocked during anastomosis. In our opinion, the major arterial supply comes from the peribiliary plexuses on both the donor and recipient sides, preserved by preserving the entire hilar plate.In this context, the rationale of the authors' cornersparing sutures is unclear. Their low complication rate could be due to increasing surgical experience and stricter selection of donors based on biliary anatomy (not specified).With our technique, (2) the current early (<3 months) and overall biliary complication rates are 6.1% and 8.9% (445 LDLTs, no donor excluded based on biliary anatomy; single/multiple ducts, 242/203), respectively.