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Endoscopic management of biliary complications after liver transplantation

Keywords: Liver transplantation/adverse effects , Postoperative complications , Biliary fistula/etiology , Bile ducts/pathology , Constriction , pathologic , Cholangiopancreatography , endoscopic retrograde/methods

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Abstract:

Objective: To retrospectively evaluate endoscopic treatmentoutcomes of biliary complications in post-liver transplants.Methods: The sample consisted of post-liver transplantationpatients referred to the Endoscopy Unit of Hospital Israelita AlbertEinstein, from July 2005 to July 2008, for endoscopic retrogradecholangiopancreatography due to suspected biliary complications.Results: Eighty-two patients were retrospectively assessed (sixwere excluded). From July 2005 to July 2008, 82 patients (57male, mean age of 49.4 years) were reviewed and 276 endoscopicretrograde cholangiopancreatographies were undertaken (3.2/patient). There were 57.3% cadaver and 42.7% living donors in thisgroup. Biliary stricture was diagnosed in 56 patients (91% wereanastomotic) and endoscopic treatment was successful in 56%(7% still in treatment). Biliary leaks were found in 28 patients (50%anastomotic). The endoscopic success rate was 62.9% and 7.1%are still in treatment. Conclusions: Post-liver transplantation biliarycomplications were relatively common and endoscopic treatmenthad a satisfactory outcome.

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